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可生物吸收聚丙交酯片(OrthoWrap可生物吸收片)在伸肌腱修复后肌腱愈合中的应用:一项对照临床试验。

Use of a bioresorbable polylactide sheet (OrthoWrap Bioresorbable sheet) on tendon healing after extensor tendon repair: a controlled clinical trial.

作者信息

Tafti Abbas Abdoli, Mohammadi Hamidreza, Rezaei Morteza, Bonadaki Seyyed Hossein Saeed

机构信息

Orthopedic Department, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Orthopedic Department, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

出版信息

BMC Musculoskelet Disord. 2025 Jan 2;26(1):1. doi: 10.1186/s12891-024-08241-z.

Abstract

BACKGROUND

Adhesion formation poses a significant challenge for both patients and hand surgeons following tendon repair. One common strategy to prevent adhesion formation is the use of physical barriers. This study aimed to compare the outcomes of extensor tendon repair with and without the application of the OrthoWrap bioresorbable Sheet, specifically in terms of adhesion prevention.

METHODS

This triple-blind randomized clinical trial was conducted on patients with trauma to the extensor zone VI tendons. Participants were randomly assigned to one of two groups. In the intervention group, OrthoWrap bioresorbable Sheet was applied in addition to the standard tendon repair protocol. Over a three-month follow-up period, the Visual Analogue Scale (VAS) score, extension lag, and metacarpophalangeal joint flexion were assessed. Additionally, the mobility of the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints was evaluated using the Strickland classification.

RESULTS

A total of 42 patients in the OrthoWrap group and 43 in the control group were evaluated over the three-month period. Both groups showed a significant reduction in mean extension lag at the metacarpophalangeal joint over time. No significant condition-by-time interactions were found for MP joint flexion or VAS scores (p > 0.05). However, significant improvements in MP joint flexion and VAS scores were observed over time. The OrthoWrap group demonstrated significantly more favorable outcomes compared to the control group.

CONCLUSION

The clinical application of OrthoWrap in extensor tendon repair demonstrated statistically significant but modest improvements in extension lag (2.5°). While patients treated with OrthoWrap showed better outcomes in Strickland's classification, the clinical significance of these small differences and their impact on patient function requires further investigation.

TRIAL REGISTRATION

IRCT, IRCT20180627040252N3. Registered 20,220,617, Https//irct.behdasht.gov.ir/trial/56,652.

摘要

背景

肌腱修复后粘连的形成对患者和手外科医生来说都是一项重大挑战。防止粘连形成的一种常见策略是使用物理屏障。本研究旨在比较应用和未应用OrthoWrap生物可吸收片进行伸肌腱修复的效果,特别是在预防粘连方面。

方法

本三盲随机临床试验针对伸肌VI区肌腱损伤患者开展。参与者被随机分为两组。干预组在标准肌腱修复方案的基础上应用OrthoWrap生物可吸收片。在三个月的随访期内,评估视觉模拟量表(VAS)评分、伸展滞后以及掌指关节屈曲情况。此外,使用斯特里克兰分类法评估近端指间(PIP)关节和远端指间(DIP)关节的活动度。

结果

在三个月的时间里,OrthoWrap组共评估了42例患者,对照组评估了43例患者。随着时间的推移,两组掌指关节的平均伸展滞后均显著降低。在掌指关节屈曲或VAS评分方面未发现显著的条件与时间交互作用(p>0.05)。然而,随着时间的推移,掌指关节屈曲和VAS评分有显著改善。与对照组相比,OrthoWrap组显示出明显更有利的结果。

结论

OrthoWrap在伸肌腱修复中的临床应用在伸展滞后方面显示出统计学上显著但适度的改善(2.5°)。虽然接受OrthoWrap治疗的患者在斯特里克兰分类中显示出更好的结果,但这些微小差异的临床意义及其对患者功能的影响需要进一步研究。

试验注册

IRCT,IRCT20180627040252N3。于2022年6月17日注册,网址为Https//irct.behdasht.gov.ir/trial/56,652。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dae2/11694381/02d6de42237e/12891_2024_8241_Fig1_HTML.jpg

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