| Summary: | 碩士 === 國立成功大學 === 醫學工程研究所碩博士班 === 97 === Complete rupture of the Achilles tendon can be experienced by both sedentary patients and athletes. Secure soft-tissue fixation is essential to direct end-to-end repair for acute tendon rupture. The three main treatments for ruptured Achilles tendon are open operative, percutaneous operative, and nonoperative. The controversy exists about the treatment of this injury. Many investigators advocate primary operative repair whereas other investigators favor a nonoperative method. Several operative techniques used to repair ruptured Achilles tendons ranging from simple end-to-end suturing to more complex repairs. However, the effect of suture methods on Achilles tendon repair have rarely been reported and interpreted so far.
To our knowledge, no investigation studies the functional and biomechanical recovery of the transected rat’s Achilles tendon repaired with different suture methods such as Modified Kessler, Bunnell, and Krackow. The purpose of this study is to investigate the optimization of suture method for Achilles tendon repair by temporal mechanical and functional evaluation and histological observation. We expect the results from this study can provide better guideline for operative ruptured tendon repair. The rat Achilles tendon repair model will be established. After sutured the rupture Achilles tendons with Modified Kessler, Modified Bunnell, and Krackow methods, the foot print of rats, the stiffness and fracture strength of healing tendon will be evaluated at 4, 7, 14, and 21 days.
The results showed that the tensile strength and stiffness of rat Achilles tendon change with body weight and age. Bunnell and Krackow methods can provide stronger tensile strength than Kessler method in ex-vivo study. In vivo study, Bunnell method had the best functional performance and the smallest gap formation. Besides, Bunnell method can provide the highest tensile strength and stiffness for stable mobility at early healing stage. In conclusion, Bunnell method is the best suture mechanically in three suture methods investigated in this study.
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