使用 Q 缝合增强对修复的屈肌的间隙形成和拉伸强度的抵抗力
Summary
在这里，我们提出了一个”Q”缝合技术，可以在肌腱修复中执行，它对修复的肌腱的间隙形成和拉伸强度的影响。Q缝合显示在增强抗拉力和肌腱修复强度方面是有效的。
Abstract
外周性显性缝合被认为能增强肌腱修复中的核心缝合强度，并降低肌腱末端之间发生间隙的风险。这里Q缝合，外设缝合的替代品，提出了用于肌腱修复。与传统的运行外设缝合线相比，其对修复肌腱的间隙形成和拉伸强度的影响。三个2股缝合线和三个4股缝合线用于修复猪肌腱。记录了执行 2Q 和运行缝合线所需的时间。修复的肌腱经过循环加载测试，确定了形成2毫米间隙的周期数。循环加载后，测量肌腱末端的间隙大小和修复的肌腱的最终强度。使用 Q 缝合的增强减少了在循环加载期间在肌腱末端显示 2 mm 间隙的肌腱数量。随着Q缝合线2股缝合线的增加，修复的肌腱的终极强度显著增加，4股缝合线减少了肌腱修复场的间隙距离。执行 2Q 缝合所需的时间明显少于运行缝合线的时间。因此，我们得出结论，Q缝合线在增强抗拉力和肌腱修复强度方面是有效的，可以替代传统的外周缝合。
Introduction
肌腱维修场地的间隙形成对肌腱的修复强度和滑翔阻力有很大影响。肌腱末端之间的间隙的后果可能最终阻碍肌腱愈合体内1。据报道，在维修现场存在大于2毫米的间隙，导致尸体手2号修复的肌腱的滑翔阻力显著增加。犬模型的研究表明，大于3毫米的间隙大小会损害肌腱愈合强度和刚度3。因此，提高肌腱末端之间的阻力和降低肌腱间隙的风险对肌腱修复至关重要。
外周缝合线的加入已被证明可以减少肌腱维修场地的间隙，从而改善修复的肌腱4、5、6,的滑翔功能。在过去的几十年里，已经开发出一些外围缝合线，包括联锁十字绣（IXS），联锁水平床垫（IHM），以及交叉链接的西尔弗斯基奥尔德和伦伯特，等等7，8，9，10。8,9,10这些外周缝合线已证明优于在肌腱修复中运行外设缝合线。然而，许多这种缝合线结构复杂，难以执行，从而限制了其广泛的应用。肌腱修复的理想缝合应旨在防止间隙的形成，同时避免在肌腱修复后向维修现场添加散装。目前，运行外设缝合仍然是一种流行的技术，由于其简单。
在最近的一项研究中，一种名为Q缝合的技术，称为Q缝合，因为它的形状类似于字母”Q”，被提出11。在这里，我们比较了这种缝合技术与运行外围缝合，以检查间隙阻力和修复肌腱的拉伸强度的差异。结果表明，Q缝合在循环载荷试验中，在提高修复肌腱的间隙阻力和最终强度方面效率更高。因此，本文旨在对如何执行Q缝合技术以及生物力学设置进行详细说明，以测试Q缝合对修复肌腱特性的影响。
Protocol
Representative Results
Discussion
目前的研究结果表明，Q缝合不仅减少了修复肌腱的间隙，提高了张力，而且省时省力。尽管如此，在目前研究中，应该注意关于肌腱修复的一些要点。
首先，我们尝试选择形状和尺寸相似的肌腱样本，因为我们不确定肌腱大小是否会对修复后拉伸强度产生显著影响。此外，肌腱样品如果无法及时修复和测试，可以保存在-20°C。研究表明，冻结肌腱不会显著改变肌腱的修复强?…
Disclosures
The authors have nothing to disclose.
Acknowledgements
作者感谢江苏省研究生研究创新项目（YKC16061）的支持。
Materials
| 4-0 suture | Ethicon, Somerville, NJ | Ethilon 1667 | |
| 6-0 suture | Ethicon, Somerville, NJ | Ethilon 689 | |
| biomechanical testing machine | Instron Corp, Norwood, MA | Instron 3365 | |
| biomechanical testing software | Instron Corp, Norwood, MA | Bluehill 2 |
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