Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Fukuoka, Japan.
Department of Life Science, Faculty of Life Science, Kyushu Sangyo University, Fukuoka City, Fukuoka, Japan.
J Hand Surg Asian Pac Vol. 2022 Jun;27(3):439-446. doi: 10.1142/S2424835522500436.
An effective suture method enables early active motion exercises and optimal post-surgical outcomes. The aim of this study is to evaluate the tensile strength of three suture configurations - horizontal mattress (HM), vertical mattress (VM) and a cross suture for repair of a tendon weave. We hypothesised that the direction of mattress sutures relative to the tendon fibres would affect the tensile strength of tendon repair. Using porcine flexor tendons and the same number of surgical sutures, three tendon weave constructs differing in the method of suture were compared: HM suture configuration (conventional technique), cross-stitch (CS) configuration (conventional technique) and VM suture configuration (novel technique). Ten pairs of each group were mounted in a material testing machine and subjected to a simple tensile test and a cyclic loading test for their biomechanical comparison. The VM group and CS group had significantly higher ultimate failure load, linear stiffness and fatigue strength as compared to the HM group. The failure mode was suture breakage or tendon rupture for the VM and the CS group, while the suture pullout of the tendon only occurred in the HM group. Among the three techniques used for repair of a tendon weave, the VM suture technique was demonstrated to have the greatest tensile strength and least associated with suture pull-out. The direction of the mattress suture in relation the direction of tendon fibres affects the strength of repair.
一种有效的缝合方法可以使患者更早地进行主动运动锻炼，并获得更好的术后效果。本研究旨在评估三种缝合方式（水平褥式、垂直褥式和十字缝合）修复肌腱编织物的拉伸强度。我们假设褥式缝线相对于肌腱纤维的方向会影响肌腱修复的拉伸强度。使用猪屈肌腱和相同数量的缝线，比较了三种不同缝合方式的肌腱编织物：水平褥式缝合（传统技术）、十字缝合（传统技术）和垂直褥式缝合（新型技术）。每组 10 对肌腱编织物被安装在材料试验机上，并进行简单拉伸试验和循环加载试验，以进行生物力学比较。与水平褥式缝合组相比，垂直褥式缝合组和十字缝合组的最终失效负荷、线性刚度和疲劳强度均显著更高。垂直褥式缝合组和十字缝合组的失效模式为缝线断裂或肌腱断裂，而水平褥式缝合组仅出现缝线从肌腱中拉出。在修复肌腱编织物的三种技术中，垂直褥式缝合技术的拉伸强度最大，与缝线拉出的相关性最小。缝线相对于肌腱纤维的方向会影响修复的强度。
