Kashuk K B, Haber E
Clin Podiatry. 1984 Apr;1(1):131-43.
The topic of artificial tendons and ligaments for the foot and ankle has been investigated. Close attention has been given to three implants, the Silastic-rod implant, the carbon-fiber implant, and Marlex mesh. A brief historical background was given to the development of the lateral ankle reconstructive procedures and to the development of the individual artificial prostheses. The biologic reactions produced by the implants have been presented. Carbon-fiber implants and Marlex mesh induce a fibrous growth that produces a neotendon or neoligament, depending on their use. Silastic-rod implantation establishes a hollow tube with qualities very similar to the normal tendon sheath. Carbon fiber and Marlex mesh are directly implanted and used as a temporary tendon or ligament. During this time, they act as a scaffold on which the new tendon or ligament is formed. Silastic-rod implants are incorporated into a two-stage tendon-graft procedure. The Silastic rod is used during stage one to develop a new tendon sheath. Placement of an autologous tendon within the newly formed sheath occurs in stage two. Details of the actual procedure have been presented. Any tendon used in the transfer should be of similar strength with similar expansive qualities. These implants have many potential uses in podiatry. They are particularly useful in trauma cases and patients that present with ankle instability. Research pertaining to the development of an ideal suture and anastomosis technique is still needed.
针对足踝部人工肌腱和韧带的课题已展开研究。重点关注了三种植入物，即硅橡胶棒植入物、碳纤维植入物和 Marlex 网。介绍了外侧踝关节重建手术发展以及各个人工假体发展的简要历史背景。阐述了植入物所引发的生物学反应。碳纤维植入物和 Marlex 网会诱导纤维生长，根据其用途可形成新的肌腱或新韧带。硅橡胶棒植入会形成一个与正常腱鞘性质非常相似的中空管。碳纤维和 Marlex 网直接植入并用作临时肌腱或韧带。在此期间，它们充当新肌腱或韧带形成的支架。硅橡胶棒植入物被纳入两阶段肌腱移植手术中。在第一阶段使用硅橡胶棒来形成新的腱鞘。在第二阶段将自体肌腱置于新形成的腱鞘内。介绍了实际手术的细节。转移中使用的任何肌腱应具有相似强度和相似的伸展特性。这些植入物在足病学中有许多潜在用途。它们在创伤病例和踝关节不稳定患者中特别有用。仍需要开展有关理想缝合和吻合技术发展的研究。
