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1.
The load-to-gap formation, maximum load, gap present at maximum load, and failure mode were compared among four suture patterns: Bunnell-Mayer, modified Kessler, Mason-Allen, and simple interrupted. Sixty-four goat tendons were sutured with 2-0 monofilament polypropylene in one of the patterns and distracted at 92 cm/min with an electrohydraulic materials testing system. All tests were filmed at 40 frames/sec with an intermittent pin registered camera. The load-to-gap formation was not significantly different among the Bunnell (13.3 +/- 1.5 newtons [N]), Kessler (12.8 +/- 1.3 N), and simple interrupted (11.7 +/- 1.7 N) patterns. The Mason-Allen pattern was significantly different )8.2 +/- 0.5 N). The Bunnell-Mayer had the highest mean maximum load to failure (43.0 +/- 1.6 N) followed by the modified Kessler (34.1 +/- 1.9 N). There was no difference between the Mason-Allen (22.9 +/- 1.4 N) and simple interrupted (21.2 +/- 1.4 N). All of the patterns permitted at least a 1 cm gap to form when the maximum load was applied. The Bunnell pattern caused severe constriction of the tendon and failed by suture material disruption. The modified Kessler caused some focal constriction, but the suture material pulled out before breaking and sliced the tendon in the process. The Mason-Allen and the simple interrupted patterns sliced the tendon as the suture pulled out of the tendon.  相似文献   

2.
Development of ischemia in healing tendons was assessed in 18 rabbits. One superficial digital flexor tendon in each rabbit was incised and anastomosed using a Bunnell pattern. The repair site was enclosed in a porous, woven Dacron tube before skin closure. The limb was immobilized with a cast. Rabbits were euthanized 1, 4, and 8 weeks after surgery, and tendons were harvested and examined microscopically. Regions of the tendon included in the suture pattern were ischemic and acellular at 1 week, while adjacent areas still containing patent vessels remained viable. Within 4 weeks, a well vascularized neotendon with collagen bundles organized parallel to the long axis of the tendon developed along the periphery and between the opposed tendon ends. After 8 weeks, the ischemic regions of the tendon had not revascularized or become integrated with the neotendon. Adjacent collagen bundles not originally included in the Bunnell pattern were integrated with neotendon collagen fibers.  相似文献   

3.
OBJECTIVE: To describe a modified 3-loop pulley suture pattern for the reattachment of canine tendons to bone along with a biomechanical comparison with the locking-loop suture. STUDY DESIGN: In vitro biomechanical study and clinical case report. ANIMALS OR SAMPLE POPULATION: Biomechanical study: 10 paired gastrocnemius tendons and calcaneii harvested from 5 canine cadavers. Case report: a Doberman with avulsion of the gastrocnemius tendon of insertion. METHODS: Biomechanical study: paired tendons were reattached to the calcaneus with either a modified 3-loop pulley pattern or a locking-loop pattern. Tensile loading to failure was performed. A direct, non-contact, method of gap measurement, using digital video, was used to measure gap formation. Load required to initiate gap formation (defined as load at a 1 mm gap) and to produce a 3 mm gap was evaluated in addition to maximum load and gap at failure. RESULTS: Mean (+/-SEM) 1 mm gap loads were 31.0+/-4.2 and 17.2+/-2.5 N, mean 3 mm gap loads were 49.1+/-2.4 and 28.9+/-3.2 N, and mean maximum loads were 72.9+/-4.3 and 55.8+/-2.2 N for the modified 3-loop pulley suture and the locking-loop suture, respectively. These differences were statistically significant (P<.05). The gap at failure was similar for both repairs. The clinical case remained sound 7 months postoperatively. CONCLUSIONS: A modified 3-loop pulley pattern is biomechanically superior to a locking-loop pattern for reattachment of the canine gastrocnemius tendon to bone and may be suitable for clinical use. CLINICAL RELEVANCE: Tendon repairs with a gap >3 mm are reported to be at increased risk of rupture during the first 6 weeks postoperatively. A modified 3-loop pulley pattern resists gap formation better than a locking-loop pattern.  相似文献   

4.
The present case report describes three heavy dogs, Caucasian Shepherd breed, with chronic complete traumatic rupture of Achilles tendon, which was repaired with two types of sutures. Surgical treatment involved shortening the Achilles tendon, and using a locking loop suture technique and own suture technique with four buttons. Additionally, positional screw and cast supported the sutures. Twelve months postoperatively no discomfort and lameness were observed on clinical examination. This paper shows that treatment of chronic complete rupture of Achilles tendon with locking loop suture and own suture technique gives good results.  相似文献   

5.
将大量肌腱缝合线溶液输入家兔耳静脉内,观察家兔的免疫反应,并分别取肌腱缝合线溶液、天然兔抗原、天然牛抗原皮下多点、腹腔、肌肉注射途径常规免疫家兔,来研究这三种抗原的免疫性强弱。结果发现,肌腱缝合线溶液的免疫反应性很弱。  相似文献   

6.
This report describes the diagnosis and treatment of a traumatic avulsion of the lateral head of the gastrocnemius muscle in a three-and-a-half-year-old male neutered Domestic Shorthaired cat. Surgical repair was achieved using a modified three-loop pulley suture pattern passed through a suture anchor inserted at the point of origin of the tendon and around the fabella. A stifle flexion device was utilised during the postoperative period to protect the repair. Follow-up at five months showed a return to normal function. This is the first report of avulsion of the lateral head of the gastrocnemius in a cat.  相似文献   

7.
Objective— To describe augmentation of primary Achilles tendon repair using suture with a semitendinosus muscle flap and report outcome in 5 dogs.
Study Design— Prospective clinical study.
Animals— Dogs (n=5) with Achilles tendon rupture (n=6).
Methods— After tendon repair with #2 polypropylene in a 3-loop pulley suture pattern, the lateral one-half of the semitendinosus muscle was transected from the ischium, rotated distally then sutured with #2 polypropylene to the calcaneus in a 3-loop pulley pattern. The epitenon was sutured to the muscle flap fascia with interrupted sutures. All dogs had a bivalved cast for 2 weeks then a cranial splint for 2–6 weeks. Lameness scores (0=stands and walks normally to 4=non-weight-bearing lameness, plantigrade stance on affected pelvic limb) were determined every 2–3 weeks postoperatively for 12 weeks. Outcome was determined from telephone questionnaire of owners.
Results— Four had lameness scores of 0, the 5th had a score of 1 at 12 weeks. Three owners were very satisfied with outcome. Minor complications included cast sores (2 dogs), infection (2), and acute swelling (1); 1 major complication occurred (infection resulting in reoperation).
Conclusions— Semitendinosus flap augmentation resulted in early return to function without prolonged postoperative immobilization. Three dogs returned to full work/activity after repair.
Clinical Relevance— Augmentation of primary Achilles tendon repair with a semitendinosus flap can be considered in dogs with chronic rupture but further investigation of the long-term outcome using this technique is needed.  相似文献   

8.
Bilateral diaphragmatic paralysis of uncertain cause developed in a 3-month-old Golden Retriever. A surgical procedure for tightening the diaphragmatic muscle was used to help alleviate the dog's respiratory distress. During thoracotomy, the central tendon of the diaphragm was plicated, using an interlocking suture pattern. The dog improved after surgery, and although complete recovery from paralysis was achieved only on one side, the dog has remained clinically normal 1 year after surgery.  相似文献   

9.
Traumatic avulsion of the triceps tendon was diagnosed in a 15-month-old, male, neutered European shorthair cat. Diagnosis was established clinically by palpation of a transverse groove proximal to the olecranon and by radiography. The avulsed end of the tendon was surgically reapposed using a modified three-loop pulley suture and horizontal mattress sutures. Postoperatively, elbow flexion was limited for three weeks with the aid of a spica splint and by exercise restriction for six weeks. The cat showed no lameness after bandage removal up to the time of writing (seven months). Although rare, triceps tendon injuries can occur after a blunt trauma and should be included in the differential diagnosis of foreleg lameness in the cat. The modified three-loop pulley suture in combination with subsequent immobilisation of the limb with a splinted bandage resulted in a successful outcome in this cat with a triceps tendon avulsion.  相似文献   

10.
OBJECTIVE: To compare effects of the locking-loop suture pattern (LLP) and 3-loop pulley (3LP) suture pattern for tenorrhaphy on the intrinsic vasculature of the superficial digital flexor tendon (SDFT) of horses in vitro after surgery. SAMPLE POPULATION: 16 forelimbs obtained from 8 mature horses. PROCEDURE: Tenotomy and subsequent tenorrhaphy was performed in anesthetized horses. Following systemic administration of heparin, horses were euthanatized and the limbs were removed and placed under tension to load the flexor tendons. The intrinsic vasculature was then perfused with a mixture of barium sulfate and water. Four-millimeter sections of the SDFT were prepared for microangiographic analysis. Mean vessel density was calculated for each section by use of a grid consisting of 1.5-mm2 vascular assessment squares (VAS). Comparisons were made among the control, LLP and 3LP groups. RESULTS: Mean +/- SD vessel density was 3.11 +/- 0.38, 1.47 +/- 0.47, and 2.01 +/- 0.63 perfused vessels/1.5 mm2 for control, LLP and 3LP groups, respectively. Significant differences in vascular density were detected between the control and 3LP groups, control and LLP groups, and LLP and 3LP groups. CONCLUSIONS AND CLINICAL RELEVANCE: Use of the LLP and 3LP pattern has deleterious effects in vitro on the intrinsic vasculature of the SDFT. However, the 3LP pattern was less disruptive to the intrinsic vasculature, compared with the effects for the LLP. Use of the 3LP tenorrhaphy suture pattern in clinical situations may result in less damage to the intrinsic vasculature of the SDFT of horses during convalescence.  相似文献   

11.
OBJECTIVE: To compare a 3-loop pulley suture pattern with 2 locking-loop sutures for the repair of components of the canine Achilles mechanism. STUDY DESIGN: In vitro biomechanical study. ANIMALS: Forty-eight paired tendons collected from 9 canine cadavers. METHODS: Paired tendons were repaired with either a 3-loop pulley suture or 2 locking-loop sutures and tensile tested to failure. To ensure accurate anastomosis gap measurement a direct, non-contact, method of gap measurement, using digital video, was devised. Load initiating gap formation (defined as load at a 1 mm gap) and load producing a 3 mm gap were evaluated in addition to maximum load, gap at failure, mode of failure, and time spent placing the sutures. RESULTS: Maximum load values were similar for both repairs. The mean 1 mm gap loads were 44.0 and 18.4 N, and the mean 3 mm gap loads were 56.3 and 34.7 N, for the 3-loop pulley pattern and the 2 locking-loops, respectively; these differences were statistically significant. The 3-loop pulley pattern was faster to place and resulted in a smaller gap at failure. All but 2 repairs failed by suture pull out. CONCLUSIONS: The 3-loop pulley pattern is more resistant to gap formation during tensile loading, and is quicker to place, than 2 locking-loop sutures. CLINICAL RELEVANCE: Gap formation can significantly delay tendon healing. Tendon repairs with a gap >3 mm are reported to be at increased risk of rupture during the first 6 weeks postoperatively.  相似文献   

12.
Resection and anastomosis of the small colon was performed on 4 horses with vascular lesions (strangulating lipoma, mesenteric tear, dissecting haematoma) or functional obstruction (stricture) of this area of the bowel. The anastomoses were performed using a variety of suture materials in 2 layers. An appositional, full-thickness, simple, interrupted pattern was used in the first layer in all cases and oversewn with either a Cushing pattern (3 cases) or a Utrecht pattern (1 case). Post-operative complications associated with suture material and surgical technique were not seen. All horses were discharged from the hospital and all were alive more than one year after discharge.  相似文献   

13.
Size 3-0 polydioxanone was used as a single strand, single braid (3 strands), or double braid (6 strands) to create six suture material-pattern combinations for equine tenorrhaphy: single-strand locking loop, single-braid locking loop, double-braid locking loop, single-strand three-loop pulley, single-braid three-loop pulley, and double-braid three-loop pulley. Maximum load to failure for the single-strand locking loop (46.1 +/- 2.9 newtons [N]) was less than for all other sutures (range, 103-155 N). The load required to form a 2 mm gap between tendon ends was greater for the single-braid three-loop pulley (66.7 +/- 6.9 N) and double-braid three-loop pulley (85.4 +/- 17.7 N) than any other sutures. The load required to produce a 10 mm gap was least for the single-strand locking loop (34.3 +/- 3.9 N) and greatest for the double-braid three-loop pulley (131.5 +/- 27.5 N). Gap between tendon ends at maximum load was greater for the single-braid (18.1 +/- 0.9 mm) and double-braid (19.2 +/- 2.2 mm) locking loops than for any other sutures. Suture material broke in 53% of the locking-loop tests but in only 17% of the three-loop pulley tests. Tendon matrix disruption accounted for 43% of the locking-loop failures and 77% of the three-loop pulley failures. The three-loop pulley pattern provided more support, less tendon distraction, and less tendon matrix constriction and distortion than the locking-loop pattern.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

14.
Superficial digital flexor luxation has been described in dogs, horses, and cattle. To the authors' knowledge, it has not been reported in cats. In the case of this report, monofilament nonabsorbable suture material was used to repair a laterally luxating superficial digital flexor tendon in a cat. The repair was similar to that which has been described in dogs. Whereas many etiologies of superficial tendon luxation have been proposed in dogs, trauma was believed to have contributed to the tendon luxation in this cat.  相似文献   

15.
A sutured tenorrhaphy technique that incorporated an autologous tendon graft was compared mechanically and histologically with a sutured tenorrhaphy at 6, 12, and 24 weeks after repair. Tenorrhaphy was performed in the forelimb tendon of the deep digital flexor muscle and the graft was taken from the hindlimb tendon of the lateral digital extensor muscle; one forelimb site included the graft, whereas the other forelimb site was not grafted. Tenotomies were made immediately proximal to the insertion of the accessory ligament into the tendon of the deep digital flexor muscle. Grafted and nongrafted tenorrhaphies were sutured with 2 polydioxanone in a modified double locking-loop pattern. Limbs were supported with a bandage and an extended elevated heel shoe that maintained the dorsal hoof wall angle at 70° to 75°; this support was removed at 12 weeks and dorsal hoof wall angle was maintained at 40° to 45° for the remainder of the study. Gap formation (2.5 ±.3 cm) was evident at all tenorrhaphy sites at 3 days on ultrasound examination. In grafted repairs, the breaking stress was increased ( P <.001) between 6 weeks (2.56 ±.44 MPa) and 12 weeks (17.69 ± 7.68 MPa), with grafted tendon having a greater breaking stress than nongrafted tendon (8.77 ± 2.5 MPa; P <.05). No differences in breaking stress were evident at 24 weeks. At 12 weeks, repair tissue in grafted tendon was histologically more mature, had less cellularity, better fibroblast orientation and more homogeneous collagen matrix than nongrafted tendon. Polydioxanone suture was still evident histologically at 24 weeks and was associated with minimal cellular reaction. Incorporation of an autologous tendon graft improved the mechanical properties and histological quality of the repair tissue in equine flexor tenorrhaphies at 12 weeks but not at 24 weeks after repair.  相似文献   

16.
Dorsal cystotomies were performed in 60 healthy dogs. Twenty bladders were closed with a single-layer interrupted appositional suture pattern, 20 with a two-layer interrupted appositional suture pattern, and 20 with a two-layer continuous inverting suture pattern. Four dogs from each group were euthanatized at hours 0, 3, 12, 18, and 24. Mechanical strength of the cystotomy closures was evaluated by calculating the circular bursting wall tension. The single-layer interrupted appositional suture pattern was as strong as both two-layer suture patterns at hours 3, 12, 18, and 24. The two-layer interrupted appositional suture pattern was as strong as the two-layer continuous inverting suture pattern during the first 24 hours.  相似文献   

17.
Both triceps tendons and the medial collateral ligaments of both stifles of 10 freshly euthanized dogs were sharply transected. One tendon and one ligament of each dog were sutured with a three loop pulley pattern, and the opposite tendons and ligaments were sutured with a locking loop pattern. The tendons and ligaments were harvested with their muscular and bony attachments. The anastomoses were slowly tested in tension until failure occurred. The amount of tensile load required to produce failure of the anastomosis, the amount of distraction of the sutured ends prior to failure, and the modes of failure were recorded. In both tendons and ligaments, the three loop pulley pattern provided significantly greater tensile strength (p < 0.01) and allowed significantly less distraction between the sutured ends (p < 0.01) than the locking loop pattern. In tendons, disruption of the suture material was the most common mode of failure with both patterns. In ligaments, both patterns failed most commonly by pulling free from the tissue.  相似文献   

18.
A Comparison of Repair Methods for Gap Healing in Equine Flexor Tendon   总被引：1，自引：0，他引：1  
In nine horses (18 forelimbs), a 3 cm section of superficial digital flexor tendon was removed and the tendons were repaired with immobilization for 6 weeks and (1) no suture (n = 6); (2) a double locking loop tenorrhaphy with carbon fiber (n = 6); or (3) a double locking loop tenorrhaphy with size 2 nylon suture (n = 6). Clinical assessment, gross evaluation, morphometry, histology, and mechanical testing were performed on two limbs from each treatment group at weeks 6, 12, and 24. At weeks 6 and 12, the unsutured tissue was less mature than the tissue sutured with nylon. By week 24, the carbon fiber repair had breaking stress (mean, 12.5 M Pa) similar to the unsutured repair (mean, 10.6 M Pa). There was necrosis and a granulomatous foreign body reaction around the carbon fiber. The nylon suture repair had significantly greater strength per unit area (mean breaking stress, 20.4 M Pa) because of a smaller area of repair tissue in the gap (mean, 3.6 cm2). At week 24, the nylon suture repair tissue was the most mature with the least inflammation of the three repair methods. A nylon double locking loop suture was the preferred method for equine flexor tenorrhaphy of a tendon gap because of greater breaking stress, histologic maturity, biocompatibility, and the adequate functional and cosmetic outcome.  相似文献   

19.
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20.
The aim of this retrospective study was to describe the use of simple interrupted suture pattern for the closure of the abdomen after ventral midline celiotomy in horses and to evaluate the prevalence of resulting incisional complications. Seventy horses undergoing abdominal surgery (2006–2015) and surviving at least 30 days were included in the study. Closure technique of the abdominal wall was performed on three layers. Linea alba was closed with a simple interrupted pattern using number two coated braided absorbable polyglycolic acid suture. Follow-up information was recovered at the 90th day postoperatively. Incisional complications considered included drainage, infection, dehiscence, and herniation. The complications observed in the present study using simple interrupted suture pattern were 4.29% (3 of 70), lower than reported in literature with different suture pattern. Simple interrupted suture pattern could be a valid option for the closure of linea alba after ventral midline celiotomy in horses.  相似文献   

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