A Biomechanical Analysis of Interference Screw Versus Bone Tunnel Fixation of Flexor Hallucis Longus Tendon Transfers to the Calcaneus
A Biomechanical Analysis of Interference Screw Versus Bone Tunnel Fixation of Flexor Hallucis Longus Tendon Transfers to the Calcaneus
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DOI：
10.1053/j.jfas.2017.04.014
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发表时间：
2017-07
影响因子：
1.3
通讯作者：
George T. Liu;Christian B. Balldin;Jacob R Zide;Christopher T. Chen
中科院分区：
文献类型：
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作者：
George T. Liu;Christian B. Balldin;Jacob R Zide;Christopher T. Chen
摘要拇长屈肌腱转移术常用于慢性跟腱断裂和慢性跟腱病的功能恢复。肌腱通常通过骨隧道或界面螺钉固定到跟骨。我们假设，对于拇长屈肌转移，采用骨隧道方法的肌腱固定在力学上上级界面螺钉固定。将8对匹配的尸体样本随机分配至骨隧道或界面螺钉技术，并加载至失效。进行生物力学分析以评估极限强度、峰值应力、杨氏模量、失效应变和应变能。采用非配对比较、配对比较和线性回归分析确定统计学显著性。界面螺钉组的杨氏模量略微降低22% ± 9%，应变能增加52% ± 18%。然而，在配对比较中，两组之间的极限强度、峰值应力或失效应变无差异。我们的研究结果表明，界面螺钉固定提供了类似的自发生物力学特性，使用骨隧道的拇长屈肌转移到跟骨。界面螺钉是将拇长屈肌腱固定到跟骨的实用选择，可通过单切口入路进行。&NA;临床证据等级：5
ABSTRACT The flexor hallucis longus tendon transfer is commonly used to restore function in chronic Achilles tendon ruptures and chronic Achilles tendinopathy. The tendon is often secured to the calcaneus either through a bone tunnel or by an interference screw. We hypothesized that tenodesis using the bone tunnel method would be mechanically superior to interference screw fixation for flexor hallucis longus transfers. Eight matched pairs of cadaveric specimens were assigned randomly to the bone tunnel or interference screw technique and were loaded to failure. Biomechanical analysis was performed to evaluate the ultimate strength, peak stress, Young's modulus, failure strain, and strain energy. Unpaired comparison, paired comparison, and linear regression analyses were used to determine statistical significance. A slight 22% ± 9% decrease in Young's modulus and a 52% ± 18% increase of strain energy were found in the interference screw group. However, no differences in ultimate strength, peak stress, or failure strain were seen between the 2 groups on paired comparison. Our findings suggest that interference screw fixation provides similar spontaneous biomechanical properties to the use of a bone tunnel for flexor hallucis longus transfer to the calcaneus. The interference screw is a practical option for fixation of the flexor hallucis longus tendon to the calcaneus and can be performed through a single incision approach. &NA; Level of Clinical Evidence: 5