Sadagatullah A N, Raghu S, Paiman M, Ismail S, Jusoh M H
Department of Orthopaedics, Universiti Sains Malaysia, Kubang Kerian, Malaysia.
Department of Anatomy and Physiology, Universiti Sultan Zainal Abidin, Kuala Terenggganu, Malaysia.
Malays Orthop J. 2025 Jul;19(2):1-8. doi: 10.5704/MOJ.2507.001.
There are various methods used to repair lacerated tendons. The minimum requirement for the best results and lowest rupture rate is the four-strand repair technique. The cruciate type of repair is among the most popular methods available but is very technical and requires expertise. An easier two-double-loop method for tendon healing is suggested in this study. This study assessed the biomechanical properties of two well-known tendon repair techniques-the modified Kessler and cruciate approaches-and two lesser-known double-loop techniques for tensile strength, stiffness, and failure mode.
Twenty-four adult chickens' Achilles tendons were randomly divided into three groups and sutured with a four-strand core suture using the four-strand modified Kessler technique, the four-strand cruciate technique, and the two-double-loop approach. Twenty-four more adult chicken Achilles tendons were acquired, and they were randomly assigned to the same three groups along with an extra running epitendinous repair. A synthetic, non-absorbable monofilament polypropylene suture was used for all repairs.
The four-strand modified Kessler, and the four-strand cruciate procedures had the lowest mean ultimate tensile strength, whereas the two double-loop techniques had the strongest. The results were dramatically impacted by using an epitendinous suture during test analysis.
The strongest and comparatively less technically complex technique used in this investigation was the two-double-loop, four-strand core suture method. The significance of the extra strength that the epitendinous suture gave was clear. Using this in a clinical setting is recommended for hand flexor tendon injuries.
修复肌腱撕裂有多种方法。要获得最佳效果和最低破裂率，最低要求是四股修复技术。十字形修复类型是最常用的方法之一，但技术要求很高，需要专业知识。本研究提出了一种更简便的用于肌腱愈合的双环法。本研究评估了两种著名的肌腱修复技术——改良凯斯勒法和十字形法——以及两种鲜为人知的双环技术的拉伸强度、刚度和失效模式的生物力学特性。
将24只成年鸡的跟腱随机分为三组，分别采用四股改良凯斯勒技术、四股十字形技术和双环法用四股核心缝线进行缝合。又获取了24只成年鸡的跟腱，将它们与额外的腱周连续修复一起随机分配到相同的三组中。所有修复均使用合成的、不可吸收的单丝聚丙烯缝线。
四股改良凯斯勒法和四股十字形法的平均极限拉伸强度最低，而两种双环技术的强度最强。在测试分析中使用腱周缝线对结果产生了显著影响。
本研究中使用的最强且技术复杂性相对较低的技术是双环四股核心缝合法。腱周缝线提供的额外强度的重要性很明显。对于手部屈肌腱损伤，建议在临床环境中使用这种方法。
