摘要
目的探讨前交叉韧带重建术中移植物预牵张对其长度的影响。方法在前交叉韧带重建术中对13例四股半腱肌、股薄肌肌腱移植物施以67N力行预牵张20min。当67N应力施加到移植物上后，立即测量移植物的长度和移植物缝合端至缝线标记点之间的长度，此后每5min测量一次，每次测量后即调整牵张力至67N。结果本组预牵张后移植物平均被延长（6．0±1．2）mm，延长比例为5．7％±1．1％，预牵张前后有显著性差异（P〈0．0005）。预牵张后移植物缝合端至缝线标记点之间的长度平均延长（3．8±0．9）mm，预牵张前后亦有显著性差异（P〈0．0005）。随访3—12个月，所有患者术后膝关节稳定性良好，膝关节功能评定：优8例，良3例，可2例。结论在前交叉韧带重建术中对四股半腱肌、股薄肌肌腱移植物施以67N的力预牵张20min，可以消除移植物的粘弹性蠕变及缝线的滑移，术后短期内关节稳定性良好。
Objective To study the effect of pretensioning on quadrupled-stranded semitendinosus and gracilis tendon graft length during anterior cruciate ligament reconstruction. Methods During operations, 67 N of tension was applied on 13 quadrupled-stranded semitendinosus and gracilis tendon grafts for 20 minutes. The distances between the two ends of the graft and between the sutured end of the graft and the marked point on the suture were measured immediately after the tension was applied, as well as every 5 minutes thereafter. Results The grafts were prolonged after pretensioning in a length of （6.0 ± 1.2 ） mm or 5.7% ± 1.1% averagely. There was Statistical significant difference in distance between the two ends of the graft before and after pretensioning（P 〈 0. 0005 ）. The increase of the distance between the sutured end of the graft and the marked point on the suture after pretensioning was （3.8 ± 0.9 ） mm. There was statistical significant difference in distance between the sutured end of the graft and the marked point on the suture before and after pretensioning（P 〈 0. 0005 ）. All patients restored the stability of the knees within 3 to 12 months follow-up. Based on the knee functional evaluating standard, 8 patients rated as excellent, 3 patients rated good and 2 rated fair. Conclusion Sixty-seven N of pretensioning for 20 minutes during anterior cruciate ligament reconstruction can minimize viscoelastic creep of graft and slippage of suture from graft, can restore the stability of the knee in a short term following reconstruction.
出处
《中国现代手术学杂志》
2006年第5期330-333,共4页
Chinese Journal of Modern Operative Surgery
关键词
前交叉韧带
重建
预牵张
粘弹性蠕变
anterior cruciate ligament
reconstruction
pretensioning
viscoelastic creep
