Mechanical compromise of partially lacerated flexor tendons.

Mechanical compromise of partially lacerated flexor tendons.
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部分撕裂的屈肌腱的机械损伤。

DOI:
10.1115/1.4023092
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发表时间:
2013
期刊:
Journal of biomechanical engineering
影响因子:
--
通讯作者:
VanderbyJr,Ray
VanderbyJr,Ray
中科院分区:
--
文献类型:
--
作者:
Kondratko,Jaclyn;Duenwald-Kuehl,Sarah;Lakes,Roderic;VanderbyJr,Ray

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肌腱的功能是传递肌肉的负荷,以移动和稳定关节并吸收冲击。撕裂肌腱的功能减弱,但临床实践通常认为只有在50%或更多的肌腱撕裂后才进行手术修复,即“50%规则”。很少有研究对50%规则提供机械的见解。在这项研究中,循环和静态应力松弛测试之前和之后的猪屈肌腱进行0.5,1.0,2.0,或2.75毫米深的横向,中间物质撕裂。弹性和粘弹性性能,如最大应力,在整个测试中的应力变化,和刚度,进行了测量和比较前和后撕裂。名义应力和刚度参数下降,虽然不成比例的幅度,增加百分比损失的横截面积。相反,使用指定载荷和恒定应变分析,残余区域的平均应力(使用撕裂横截面处的剩余完整区域确定)显示出从47.2%撕裂开始的应力集中显著增加。在50%撕裂附近开始的应力集中的显著增加提供了对50%规则的机械见解。此外,粘弹性应力参数急剧下降后,只有8.2%的撕裂表明,时间依赖性的机制,保护组织在冲击载荷是高度妥协,无论撕裂的大小。
Tendons function to transmit loads from muscle to move and stabilize joints and absorb impacts. Functionality of lacerated tendons is diminished, however clinical practice often considers surgical repair only after 50% or more of the tendon is lacerated, the “50% rule.” Few studies provide mechanical insight into the 50% rule. In this study cyclic and static stress relaxation tests were performed on porcine flexor tendons before and after a 0.5, 1.0, 2.0, or 2.75 mm deep transverse, midsubstance laceration. Elastic and viscoelastic properties, such as maximum stress, change in stress throughout each test, and stiffness, were measured and compared pre- and post-laceration. Nominal stress and stiffness parameters decreased, albeit disproportionately in magnitude, with increasing percent loss of cross-sectional area. Conversely, mean stress at the residual area (determined using remaining intact area at the laceration cross section) exhibited a marked increase in stress concentration beginning at 47.2% laceration using both specified load and constant strain analyses. The marked increase in stress concentration beginning near 50% laceration provides mechanical insight into the 50% rule. Additionally, a drastic decrease in viscoelastic stress parameters after only an 8.2% laceration suggests that time-dependent mechanisms protecting tissues during impact loadings are highly compromised regardless of laceration size.
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