通道辅助微创缝合与两种常用跟腱缝合方式的生物力学研究

目的:通过对比通道辅助跟腱微创缝合方式(CAMIR)与2种临床最常用的跟腱缝合方式的生物力学强度,验证CAMIR微创缝合方式同样能够达到常规缝合方式的力学强度,为临床推广应用提供可靠的理论依据。方法:将27支跟腱样本随机分为3组(每组9支),分别是CAMIR组、经典微创Ma-Griffith组、标准切开Krackow组。所有跟腱样本首先预加载50N,2min。然后以20N-100N,1Hz,循环1000次。如果缝合未失效,则以20 mm/s的速度将样本拉伸至失效。通过实验仪上的传感器自动记录循环1000次时整个缝合结构的伸长量,记录拉伸失效时整个缝合结构的伸长量以及最大负荷,并计算单纯拉伸阶段缝合结构的抗拉伸硬度。结果:CAMIR的循环1000次结束时伸长量(P=0.581)、缝合失效时伸长量(P=0.799)、缝合失效时最大负荷(P=0.278)、单纯拉伸过程中抗应变硬度(P=0.935)与常用的Ma-Griffith、Krackow缝合方式均无明显差异。结论:CAMIR缝合方式强度可靠,为术后进行早期功能康复训练提供力学保障,同时能够有效避免腓肠神经损伤,是临床上值得推荐的微创缝合方式。

A Biomechanical and Comparative Study on Channel-assisted Minimally Invasive Repair System and Two Common Kinds of Suture Configuration

ABSTRACT Objective: To provide reliable evidence for clinical application, this study compared the biomechanical strength of a noval Achilles tendon minimally invasive suture with two types of common used Achilles tendon suture. Methods: 27 Achilles tendon samples were randomly divided into 3 groups (9 in each group): CAMIR group, Ma-Griffith group and Krackow group. All Achilles tendon samples were preloaded with 50 N, 2 min. And then circulated 1000 times at 20N-100N, 1Hz. If the suture configuration did not fail, the specimen was stretched to failure at a speed of 20 mm/s. The elongation of the whole stitch structure and maximum loading were recorded automatically by the sensor on the tester. And the tensile hardness of the stitch structure was calculated. Results: The elongation at the end of 1000 cycles (P = 0.581), elongation at suture failure (P = 0.799), maximal load at suture failure (P = 0.278) and strain hardening during tensile alone (P = 0.935) of CAMIR had no significant difference with Ma-Griffith and Krackow suture configuration. Conclusion: The suture strength of CAMIR is reliable, it can be used for early rehabilitation after operation, and effectively avoid the injury of sural nerve.