Gabuzda G M, Lovallo J L, Nowak M D
Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington.
J Hand Surg Br. 1994 Jun;19(3):397-400. doi: 10.1016/0266-7681(94)90098-1.
A study was designed to investigate the tensile strength of the end-weave method of tendon repair. Flexor tendons were removed from 13 fresh-frozen human cadavers, transected and repaired with the end-weave technique varying from one to five weaves, with two suture techniques, the commonly used horizontal mattress suture and a new method we have termed the cross stitch. The repairs were then tested in tension to failure on a Materials Test System (MTS) biomechanical testing device. Comparisons were also made to tensile strengths of intact whole tendons, tendon-bone insertions, and distal reinsertion techniques. Tensile strength increased linearly with the number of weaves for both suture methods. The cross stitch was found to have significantly greater strength per weave compared to the horizontal mattress suture (P < 0.05). Three out of five trials of five weaves done with the cross stitch actually failed at the tendon itself first, rather than through the repair, which was the failure mode for all other trials. The results from this in vitro model suggest that active rehabilitative exercises might safely be performed in the immediate post-operative period after procedures that involve tendon weaving.
一项研究旨在调查肌腱修复的端-编织法的拉伸强度。从13具新鲜冷冻的人体尸体上取下屈肌腱，横断并用端-编织技术修复，编织数从1到5个，采用两种缝合技术，即常用的水平褥式缝合和我们称为十字缝合法的新方法。然后在材料测试系统（MTS）生物力学测试装置上对修复后的肌腱进行拉伸直至破坏测试。还将结果与完整的整条肌腱、肌腱-骨连接处以及远端重新植入技术的拉伸强度进行了比较。两种缝合方法的拉伸强度均随编织数呈线性增加。发现十字缝合法每个编织的强度明显高于水平褥式缝合（P < 0.05）。用十字缝合法进行的五次编织中的五次试验中有三次实际上首先在肌腱本身处断裂，而不是通过修复处断裂，而其他所有试验的失败模式都是通过修复处断裂。这个体外模型的结果表明，在涉及肌腱编织的手术后即刻，可以安全地进行主动康复锻炼。
