Buschmann Johanna, Feiner Kimberly, Ongini Esteban, Snedeker Jess G, Giovanoli Pietro, Calcagni Maurizio
Department of Plastic Surgery and Hand Surgery, University Hospital of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland.
University Clinic Balgrist, Orthopaedic Biomechanics, Forchstrasse 340, 8008, Zurich, Switzerland.
Heliyon. 2024 Sep 20;10(18):e38215. doi: 10.1016/j.heliyon.2024.e38215. eCollection 2024 Sep 30.
Tendon injures rank as the second most common hand injuries, and unsatisfactory repair can significantly impact a patient's everyday life. Over the years, various suture techniques have been studied in the pursuit of finding the optimal repair method. The ideal tendon repair should achieve maximum strength, while being easy to perform and minimizing tissue trauma. This study aims to compare the mechanical properties of the cross-locked U-Tang 4-strand suture to its unmodified version, the U-Tang 4-strand suture, to assess which technique offers greater repair strength.
Sixteen Achilles tendons from New Zealand White rabbits were randomly assigned to one of two suture technique groups; an original U-Tang 4-strand suture or a cross-locked U-Tang 4-strand suture, both performed using a 4-0 Supramid thread. The specimens were tested in uniaxial tension after a preconditioning phase. Cross-sectional area, load until failure, gap formation, stiffness, elastic modulus, and failure stress were determined.
The standard U-Tang 4-strand suture withstood a maximum force of 25.48 ± 6.06 N, while the cross-locked version endured 33.90 ± 6.09 N. This indicates that the modified version demonstrated significantly greater strength (p = 0.021). The elastic modulus of the cross-locked U-Tang 4-strand suture (0.02 ± 0.003 MPa) was significantly higher than that of the original version (0.01 ± 0.006 MPa) (p = 0.028). No significant differences were observed regarding the cross-sectional area, load at 2 mm gap formation, stiffness and failure stress.
Employing the cross-locked U-Tang 4-strand suture results in a significantly greater maximum force and elastic modulus compared to the original U-Tang 4-strand suture, utilizing the same thread and number of strands and knots. Therefore, the cross-locking version provides an alternative for achieving more stable initial repair strength.
肌腱损伤是手部第二常见的损伤，修复效果不佳会严重影响患者的日常生活。多年来，人们研究了各种缝合技术，以寻求最佳的修复方法。理想的肌腱修复应具备最大强度，操作简便且使组织创伤最小化。本研究旨在比较交叉锁定U型四股缝合线与其未改良版本U型四股缝合线的力学性能，以评估哪种技术能提供更强的修复强度。
将16条新西兰白兔的跟腱随机分配到两种缝合技术组之一；一种是原始的U型四股缝合线，另一种是交叉锁定U型四股缝合线，均使用4-0 Supramid线进行操作。在预处理阶段后，对标本进行单轴拉伸测试。测定横截面积、直至断裂的载荷、间隙形成、刚度、弹性模量和断裂应力。
标准U型四股缝合线承受的最大力为25.48±6.06N，而交叉锁定版本承受33.90±6.09N。这表明改良版本的强度显著更高（p=0.021）。交叉锁定U型四股缝合线的弹性模量（0.02±0.003MPa）显著高于原始版本（0.01±0.006MPa）（p=0.028）。在横截面积、2mm间隙形成时的载荷、刚度和断裂应力方面未观察到显著差异。
与原始U型四股缝合线相比，使用交叉锁定U型四股缝合线在使用相同的线、股数和结数的情况下，能产生显著更大的最大力和弹性模量。因此，交叉锁定版本为实现更稳定的初始修复强度提供了一种替代方案。
