Background

The success of surgical repairs rely on the effectiveness and integrity of the surgical knots used to secure the repair. The purpose of this study is to examine and compare the performance of the Nice knot, the modified Nice knot, and a commonly used combination of surgeons' and square knots with respect to cyclic loading and load-to-failure usiflueng a high-strength suture composed of ultra-high molecular weight polyethylene in the hands of experienced surgeons.

Methods

Two experienced surgeons threw 3 different knot types 9 times, consisting of the Nice knot, modified Nice knot, and a surgeon's knot utilizing Ultrabraid #2 sutures. Each knot was subject to cyclic loading and load to failure testing.

Findings

Both surgeons had similar displacement data for the surgeon's knot, while the identity of the surgeon impacted displacement for the Nice knot (p = 0.03) and the modified Nice knot (p = 0.0002). The load to failure for the modified Nice knot (p < 0.001) and the Nice knot (p = 0.001) were significantly impacted by the surgeon tying the knot, while the surgeon's knot was not. Specimens failed where the sutures passed through the loop at the “base” of the knot.

Interpretations

The strength and integrity of complex surgical knots are variable between surgeons. While the proposed Modified Nice Knot has a theoretical advantage because the half hitches reinforce the primary knot, in load to failure testing both the Modified Nice Knot and the Nice Knot failed where the suture passed through the loop in the primary knot.

中文翻译：

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Nice结、改良Nice结和外科医生结的力学性能比较

背景

手术修复的成功取决于用于固定修复的手术结的有效性和完整性。本研究的目的是检查和比较 Nice 结、改进的 Nice 结以及常用的外科医生结和方结组合在使用高强度缝合线的循环载荷和载荷失效方面的性能由经验丰富的外科医生手中的超高分子量聚乙烯组成。

方法

两名经验丰富的外科医生将 3 种不同的结类型打了 9 次，包括 Nice 结、改良的 Nice 结和使用 Ultrabraid #2 缝合线的外科医生结。每个结都经受循环载荷和载荷失效测试。

发现

两位外科医生的外科医生结的位移数据相似，而外科医生的身份影响 Nice 结 ( p  = 0.03) 和修改后的 Nice 结 ( p  = 0.0002) 的位移。改良的 Nice 结 ( p  < 0.001) 和 Nice 结 ( p  = 0.001) 的失效负荷受到外科医生打结的显着影响，而外科医生的结则没有。标本在缝合线穿过结“底部”处的环处失败。

解释

复杂手术结的强度和完整性因外科医生而异。虽然提议的改良尼斯结具有理论上的优势，因为半结加强了初级结，但在负载失效测试中，改良尼斯结和尼斯结在缝合线穿过初级结中的环时都失败了。