Gap Resistance and Tensile Strength of a Q Suture Technique During Curved Loading: An Ex Vivo Porcine Flexor Tendon Study

IF 2.1 2区 医学 Q2 ORTHOPEDICS
Si Wei Xu BM , Wei Feng Mao PhD , Ya Fang Wu MD
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Abstract

Purpose

This study aimed to determine the mechanical properties of the double Q suture technique in angular motion and to compare the gap formation associated with tendon repairs during curved and linear loading.

Methods

Eighty porcine flexor tendons were repaired with one of two 4-strand sutures: double Q suture or double modified Kessler plus peripheral running sutures. The repaired tendons were cyclically loaded sequentially against a pulley with a radius of 2.0, 1.5, and 1.0 cm or linearly without any pulleys. The number of tendons that formed an initial or 2-mm gap at the repair site during cyclic loading, the gap size between tendon ends when cyclic loading ended, and the ultimate strength were recorded.

Results

The gap at the repair site formed gradually from the dorsal to volar aspect during curved loading. No double Q repairs, but half of the double Kessler plus running suture repairs, formed an initial or 2-mm gap on the volar aspect during curved loading. The double Q group had a significantly smaller gap size on the dorsal aspect than the double Kessler plus running suture group at all three radii of curvature. The ultimate strength was similar between the two groups. There were no significant differences in linear motion between these two repairs.

Conclusions

The double Q suture is superior to the conventional 4-strand tendon core suture plus running peripheral sutures in gap resistance in angular motion. This study provides insight into the formation of an unbalanced gap on the dorsal and volar aspects of tendon repair during curved loading.

Clinical Relevance

The double Q suture provides a simple and efficient option for flexor tendon repair considering the high risk of gap formation on the dorsal aspects of the tendon repair in angular motion.
弯曲载荷时Q缝合技术的间隙阻力和拉伸强度:猪屈肌腱离体研究。
目的:本研究旨在确定双Q缝线技术在角运动中的力学特性,并比较弯曲和线性载荷下与肌腱修复相关的间隙形成。方法:对80只猪屈肌腱采用双Q线或双改良Kessler加外周线两种四股缝合方式中的一种进行修复。修复后的肌腱依次在半径为2.0、1.5和1.0 cm的滑轮上循环加载,或在没有任何滑轮的情况下线性加载。记录循环加载时修复部位形成初始间隙或2mm间隙的肌腱数、循环加载结束时肌腱端间隙大小、极限强度。结果:在弯曲加载过程中,修复部位的间隙由背侧向掌侧逐渐形成。没有双Q修复,但一半的双Kessler加上运行缝线修复,在弯曲加载期间在掌侧形成初始或2毫米的间隙。双Q组在所有三个曲率半径上的背侧间隙尺寸明显小于双Kessler加运行缝合组。两组的极限强度相似。两种修复方法在直线运动方面无显著差异。结论:在角运动间隙阻力方面,双Q线缝合优于常规4股腱核缝合+外周线缝合。这项研究提供了在弯曲加载期间肌腱修复的背侧和掌侧方面形成不平衡间隙的见解。临床意义:考虑到在角度运动时肌腱修复的背侧形成间隙的高风险,双Q缝线为屈肌腱修复提供了一种简单有效的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.20
自引率
10.50%
发文量
402
审稿时长
12 weeks
期刊介绍: The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.
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