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首页> 外文期刊>Journal of orthopaedic research >Early healing of flexor tendon insertion site injuries: Tunnel repair is mechanically and histologically inferior to surface repair in a canine model.
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Early healing of flexor tendon insertion site injuries: Tunnel repair is mechanically and histologically inferior to surface repair in a canine model.

机译：屈肌腱插入部位损伤的早期愈合：在犬模型中，隧道修复在机械和组织学上均不如表面修复。

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摘要

Orthopedic injuries often require surgical reattachment of tendon to bone. Tendon ends can be sutured to bone by direct apposition to the bone surface or by placement within a bone tunnel. Our objective was to compare early healing of a traditional surface versus a novel tunnel method for repair of the flexor digitorum profundus (FDP) tendon insertion site in a canine model. A total of 70 tendon-bone specimens were analyzed 0, 5, 10 or 21 days after injury and repair, using tensile and range of motion mechanical testing, histology and densitometry. Ultimate force (a measure of repair strength) did not differ between surface and tunnel repairs at day 0. Both repair types had reduced strength at 10 and 21 days compared to 0 days, indicative of deterioration of suture grasping strength (tendon softening). At 21 days, tendons repaired in a bone tunnel had 38% lower ultimate force compared to surface repairs (p = 0.017). Histological findings were comparable between repair groups at 5 and 10 days but differed at 21 days, when we saw evidence of maturation of the tendon-bone interface in the surface repairs compared to an immature fibrous interface with no evidence of tendon-bone integration in the tunnel repairs. After accounting for bone removed by the tunnel, no difference in bone mineral density or trabecular bone volume existed between surface and tunnel repairs. If the results of our animal study extend to healing of the human FDP insertion, they indicate that FDP tendons should be reattached to the distal phalanx by suture to the cortical surface rather than suture in a bone tunnel.
机译：骨伤通常需要通过手术将肌腱重新固定到骨头上。肌腱末端可通过直接并置在骨骼表面或放置在骨骼隧道内而缝合到骨骼上。我们的目的是比较传统表面的早期愈合与新型隧道方法在犬模型中修复趾深屈肌腱（FDP）肌腱插入部位的效果。使用拉伸和运动机械测试范围，组织学和光密度测定法，在损伤和修复后第0、5、10或21天对总共70个腱骨标本进行了分析。在第0天，表面修补和隧道修补的极限力（修补强度的度量）没有差异。两种修补类型在10天和21天的强度均比0天降低，表明缝合线抓握强度下降（肌腱软化）。与表面修复相比，在第21天，在骨隧道中修复的肌腱的极限力降低了38％（p = 0.017）。修复组在第5天和第10天的组织学结果相当，但在第21天时有所不同，当我们看到表面修复中肌腱-骨界面成熟的证据与未成熟的纤维界面没有证据表明肌腱-骨整合在一起时隧道维修。考虑到隧道去除的骨骼后，表面和隧道修复之间的骨矿物质密度或小梁骨体积没有差异。如果我们的动物研究结果扩展到人类FDP插入的愈合，则表明FDP肌腱应通过缝合皮层表面而不是在骨隧道中缝合而重新附着于指骨远端。

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