摘要
为使修复肌腱有足够张力强度，研究了肌腱内横向结扎缝合法。对兔跟腱一侧用该法缝合（实验组），对侧用Ｋｅｓｌｅｒ法缝合（对照组），术后０～５周每组８只，经手术显微镜、光镜及电镜观察，并进行详细生物力学性能测试。结果：（１）实验组组织学观察优于对照组。（２）实验组载荷、强度极限、拉伸刚度、比能及应变率分别较对照组高４８．８％、５５．３％、３３．９％、７９．２％及４６．９％，统计学分析两组有非常显著性差异（Ｐ值＜０．０１）。（３）临床应用１５３例，术后未用外固定而早期活动者占７４％，随访１２３例，按Ｔ．Ａ．Ｍ标准判定疗效，总优良率９０％，可５．７％，差４．３％。说明该法修复的肌腱生物力学性能好，有利于术后早期活动及解除固定。
The authors designed the transverse ligation suture within the tendon,in order to give adequate tensile strength to the repaired tendons. Experimental study was carried out in rabbits and biomechanical investigations were conducted during tendon healing period. On the experimental side,the Achilles tendon was severed and sutured with transverse ligation and on the contralateral side, Kessler's repair method was used for control. The operating microscope, light and electron microscopes were used for the observation 0～5 weeks after surgery. Totally eight rabbits were observed each time and 8 observations were performed during the whole course of the experiment. Biomechanical studies were conducted at the time of microscopic observations. The results revealed that,histologically the healing in the experimental group was better than in the controls; the load strength limit, the stretch rigidity, the specific energy and the straining rate were higher in the experimental group than that in the controls for 48.4%, 55.3%, 33.9%, 79.2% and 46.9%, respectively, showing very significant difference between the two group (P<0.01). The method was used clinically in 153 cases and 74% of the cases without external fixation had early activity; and in the follow-up, 123 cases were evaluated according to T.A.M. standard and excellent results were seen in 90% of the cases. 4.3% of the cases had poor results. The authors concluded that, the method of transverse ligation suture within the tendon demonstrated a favorable nature of biomechanics after tendon healing ;it is also beneficial for early activity after surgery and after the operation without the use of external fixation.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1997年第3期171-174,共4页
Chinese Journal of Orthopaedics
关键词
肌腱
缝合法
张力强度
Tendon Method of suture Strain Tensile strength
