新型肌腱接合技术的生物力学评估：肌腱转位的潜在应用
Biomechanical Evaluation of Novel Tendon Coaptation Technique: A Potential Application for Tendon Transfers.
作者信息
Collins Devin W, Diaz Miguel A, Coutelle Nino, McLaughlin Mariel, Pamic Damir, Simon Peter, Doarn Michael C
机构信息
Florida Orthopaedic Institute, Tampa, FL.
Department of Orthopaedics & Sports Medicine, University of South Florida, Tampa, FL.
出版信息
J Hand Surg Glob Online. 2024 Dec 10;7(2):152-157. doi: 10.1016/j.jhsg.2024.11.007. eCollection 2025 Mar.
PURPOSE
The purpose of this study was to evaluate the biomechanical performance and time to completion of the Pulvertaft weave technique, the CoNextions tendon repair system only, and a combination of single Pulvertaft weave with the CoNextions repair.
METHODS
A total of 22 cadaveric hands were dissected, and the extensor pollicis longus tendons were harvested and divided into the following three groups: (1) Pulvertaft weave, (2) Pulvertaft weave + CoNextions, and (3) CoNextions. Each sample underwent axial loading in a cyclical fashion, followed by ramp to failure. Metrics of interest were suture time, displacement, stiffness, ultimate failure load, and failure mechanism were recorded.
RESULTS
Time required to instrument each configuration was significantly different across all groups; CoNextions group was the fastest. For cyclic loading, no significant differences in elongation were detected between the groups. The displacement at ultimate failure load, on average, for the Pulvertaft (10.6 mm) and the Pulvertaft and CoNextions combination (10.2 mm) were not significantly different compared with CoNextions (6.5 mm). The stiffness during cyclic loading was similar between the Pulvertaft (38.8 N/mm) and the Pulvertaft and CoNextions combination (36.7 N/mm), and both were found to be significantly stiffer compared with the CoNextions (28.0 N/mm). During the ramp to failure, no significant differences in stiffness were detected. The Pulvertaft had the largest ultimate failure load at 67.5 N.
CONCLUSIONS
The Pulvertaft weave and CoNextions tendon repair device demonstrated similar performance to traditional Pulvertaft tendon weave. The combination technique is faster than the traditional tendon weave and displayed improved performance compared with CoNextions repair alone.
CLINICAL RELEVANCE
The combined use of novel tendon repair with a single tendon weave allows for faster tendon coaptation and equivalent strength as a Pulvertaft weave.
目的
本研究旨在评估普尔弗塔夫编织技术、仅使用CoNextions肌腱修复系统以及单普尔弗塔夫编织与CoNextions修复相结合的生物力学性能和完成时间。
方法
共解剖22具尸体手，采集拇长伸肌腱并分为以下三组：（1）普尔弗塔夫编织组，（2）普尔弗塔夫编织+CoNextions组，（3）CoNextions组。每个样本以循环方式进行轴向加载，然后逐渐加载至破坏。记录感兴趣的指标，包括缝合时间、位移、刚度、极限破坏载荷和破坏机制。
结果
所有组之间处理每种构型所需的时间有显著差异；CoNextions组最快。对于循环加载，各组之间在伸长方面未检测到显著差异。在极限破坏载荷下，普尔弗塔夫组（10.6毫米）和普尔弗塔夫与CoNextions组合组（10.2毫米）的平均位移与CoNextions组（6.5毫米）相比无显著差异。普尔弗塔夫组（38.8牛/毫米）和普尔弗塔夫与CoNextions组合组（36.7牛/毫米）在循环加载期间的刚度相似，且两者均显著比CoNextions组（28.0牛/毫米）更硬。在逐渐加载至破坏过程中，未检测到刚度有显著差异。普尔弗塔夫组的极限破坏载荷最大，为67.5牛。
结论
普尔弗塔夫编织和CoNextions肌腱修复装置表现出与传统普尔弗塔夫肌腱编织相似的性能。联合技术比传统肌腱编织更快，且与单独的CoNextions修复相比性能有所改善。
临床意义
新型肌腱修复与单肌腱编织联合使用可实现更快的肌腱对接，且强度与普尔弗塔夫编织相当。
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