Musculus flexor digitorum profundus aksesuar başı tendonunun alternatif greft olarak kullanılabilirliğinin araştırılması

Year 2022, Volume: 15 Issue: 2, 263 - 272, 31.08.2022

İsmail Yağmurhan Gilan , Coşar Uzun , Vedia Bennu Gilan , Alev Bobus Örs , Nurten Erdal

https://doi.org/10.26559/mersinsbd.1114923

Abstract

Amaç: Son yıllarda, artan cerrahi rekonstüksiyon teknikleri ile tendon transferleri sık yapılan operasyonlardan biri haline gelmiştir. Trafik kazaları, kesici alet yaralanmaları ya da bazı romatizmal hastalıkların yarattığı dejeneratif hasarlar sonucunda tendon grefti uygulamaları bir gereklilik haline gelmiştir. Literatürde en çok kullanılan tendon greft donörleri musculus palmaris longus, musculus plantaris, musculus extensor digitorum longus, musculus extensor indicis ve musculus gracilis olarak geçmektedir. Birçok tendon greft donörü olmasına rağmen, farklı kullanım alanları ve varyatif durumlar nedeni ile zaman zaman da alternatif tendon greft donörlerine ihtiyaç duyulmaktadır. Biz de buradan yola çıkarak musculus flexor digitorum profundus aksesuar başının tendon grefti olarak kullanılabilirliğini araştırmayı hedefledik. Yöntem: Çalışmamızda, musculus flexor digitorum profundus aksesuar başı tendonunun, tendon grefti için donör olup olamayacağı iki basamakta incelendi. Birinci aşamada morfometrik olarak uygunluğu, ikinci aşamada ise biyomekanik olarak uygunluğu test edilerek güncel olarak kullanılan musculus palmaris longus ve musculus plantaris tendonlarıyla karşılaştırıldı. Bu amaçla musculus palmaris longus, musculus plantaris ve musculus flexor digitorum profundus aksesuar başının tendonları kullanıldı. Erişkin 11 kadavradan alınan kasların ve tendonlarının uzunlukları, kalınlıkları ve genişlikleri ölçüldü. Elde edilen parametreler birbirleriyle karşılaştırıldı. Alındıkları ekstremitelerin de uzunluk ve genişlikleri ölçülerek, tendonlarla aralarındaki korelâsyonlara bakıldı. Germe test cihazı kullanılarak; maksimum kopma kuvveti, maksimum deformasyon, tendon kopuncaya kadar depolanan enerji, sertlik, maksimum stres, maksimum strain, esneklik katsayısı ve dayanıklılık parametreleri ölçülüp, tendonların biyomekanik özellikleri değerlendirildi. Bulgular: Yapılan analizler sonucunda; hem morfometrik verilerde hem biyomekanik verilerde benzerlikler elde edildi. Sonuç: Sonuç olarak ele alınan aksesuar tendonun morfometrik olarak uygun olduğu, biyomekanik olarak kısmen yeterli olduğu sonucuna varıldı.

Keywords

Tendon grefti, tendon morfometrisi, tendon biyomekaniği

Supporting Institution

Mersin Üniversitesi Bilimsel Araştırmalar Projeleri Birimi

Project Number

BAP-SBE TTB (YG) 2013-4 YL

Investigation of the use tendon of the accessory head of flexor digitorum profundus muscle as an alternative graft

Abstract

Aim: In recent years, tendon transfers have become one of the most frequently performed operations with increasing surgical reconstruction techniques. Tendon graft applications have become a necessity as a result of traffic accidents, sharp tool injuries or degenerative damage caused by some rheumatic diseases. The most commonly used tendon graft donors in the literature are palmaris longus muscle, plantaris muscle, extensor digitorum longus muscle, extensor indicis muscle and gracilis muscle. Although there are many tendon graft donors, alternative tendon graft donors are needed from time to time due to different areas of use and variability. Based on this, we aimed to investigate the usability of the accessory head of the flexor digitorum profundus muscle as a tendon graft. Method: In our study, we investigated whether the tendon of the accessory head of flexor digitorum profundus muscle could be a donor site for tendon grafting in two steps. Morphometric suitability in the first step and biomechanical suitability in the second step were tested and compared with currently used palmaris longus muscle and plantaris muscle tendons. For this purpose, palmaris longus muscle, plantaris muscle and the accessory head of flexor digitorum profundus muscle tendons were used. The lengths, thicknesses and widths of the muscles and tendons taken from 11 adult cadavers were measured. Obtained parameters were compared with each other. The length and width of the extremities from which they were taken were also measured and the correlations between them and the tendons were checked. By using tensile device; maximum rupture force, maximum deformation, stored energy, stiffness, maximum stress, maximum strain, flexibility coefficient and endurance parameters were measured and biomechanical properties of tendons were evaluated. Results: Similarities were obtained in both morphometric and biomechanical datas. Conclusion: As a result, it was determined that the considered accessory tendon was morphometrically suitable and partially sufficient biomechanically

Keywords

Tendon graft, tendon morphometry, tendon biomechanics

Project Number

BAP-SBE TTB (YG) 2013-4 YL

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