新型肌腱贴合技术的生物力学评价：肌腱转移的潜在应用

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-03-01 DOI:10.1016/j.jhsg.2024.11.007

Devin W. Collins DO , Miguel A. Diaz MS , Nino Coutelle MD , Mariel McLaughlin MD , Damir Pamic BS , Peter Simon PhD , Michael C. Doarn MD

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引用次数: 0

摘要

目的：本研究的目的是评估粉塔夫脱编织技术、CoNextions肌腱修复系统和单一粉塔夫脱编织与CoNextions修复的组合的生物力学性能和完成时间。方法解剖22只尸体手，采集拇长伸肌腱，将其分为3组：(1)粉状编织组，(2)粉状编织+结缔组织组，(3)结缔组织组。每个样品都以周期性的方式进行轴向加载，然后逐渐失效。感兴趣的指标是缝合时间、位移、刚度、最终破坏载荷和破坏机制的记录。结果各组仪器配置所需时间差异有统计学意义；CoNextions组是最快的。对于循环加载，各组之间伸长率无显著差异。在极限破坏荷载下，powrtaft （10.6 mm）和powrtaft和CoNextions组合（10.2 mm）的平均位移与CoNextions （6.5 mm）相比没有显著差异。在循环加载过程中，powrtaft （38.8 N/mm）和powrtaft与CoNextions组合（36.7 N/mm）的刚度相似，且两者的刚度均显著高于CoNextions （28.0 N/mm）。在过渡到失效的过程中，没有检测到明显的刚度差异。结论粉塔夫脱织和contions肌腱修复装置与传统粉塔夫脱织具有相似的性能。该组合技术比传统的肌腱编织更快，与单独的CoNextions修复相比，显示出更高的性能。新型肌腱修复与单一肌腱编织的联合使用允许更快的肌腱接合和与粉状编织相当的强度。

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Biomechanical Evaluation of Novel Tendon Coaptation Technique: A Potential Application for Tendon Transfers

Purpose

The purpose of this study was to evaluate the biomechanical performance and time to completion of the Pulvertaft weave technique, the CoNextions tendon repair system only, and a combination of single Pulvertaft weave with the CoNextions repair.

Methods

A total of 22 cadaveric hands were dissected, and the extensor pollicis longus tendons were harvested and divided into the following three groups: (1) Pulvertaft weave, (2) Pulvertaft weave + CoNextions, and (3) CoNextions. Each sample underwent axial loading in a cyclical fashion, followed by ramp to failure. Metrics of interest were suture time, displacement, stiffness, ultimate failure load, and failure mechanism were recorded.

Results

Time required to instrument each configuration was significantly different across all groups; CoNextions group was the fastest. For cyclic loading, no significant differences in elongation were detected between the groups. The displacement at ultimate failure load, on average, for the Pulvertaft (10.6 mm) and the Pulvertaft and CoNextions combination (10.2 mm) were not significantly different compared with CoNextions (6.5 mm). The stiffness during cyclic loading was similar between the Pulvertaft (38.8 N/mm) and the Pulvertaft and CoNextions combination (36.7 N/mm), and both were found to be significantly stiffer compared with the CoNextions (28.0 N/mm). During the ramp to failure, no significant differences in stiffness were detected. The Pulvertaft had the largest ultimate failure load at 67.5 N.

Conclusions

The Pulvertaft weave and CoNextions tendon repair device demonstrated similar performance to traditional Pulvertaft tendon weave. The combination technique is faster than the traditional tendon weave and displayed improved performance compared with CoNextions repair alone.