Repair of flexor digitorum profundus to distal phalanx: a biomechanical evaluation of four techniques. 2011

Steve K Lee, and Marc Fajardo, and George Kardashian, and Jason Klein, and Peter Tsai, and Dimitrios Christoforou
Hospital for Special Surgery, Hand & Upper Extremity Surgery Service, 535 East 70th St., New York, NY 10021, USA. leest@hss.edu

OBJECTIVE Many techniques for repair of the flexor digitorum profundus to the distal phalanx show excessive gapping with variable clinical results. The purpose of this study was to test the biomechanical characteristics of an anchor-button (AB) technique, as compared to 3 other techniques. METHODS Twenty-four fresh-frozen human cadaveric fingers were randomized to 4 groups, 6 in each: group 1, 2-strand Bunnell suture button pullout technique; group 2, modified Kessler suture and 2 retrograde anchors; group 3: locking Krakow suture with 2 retrograde anchors; group 4, AB technique incorporating a 2-part repair, consisting of a locking dorsal Krakow suture with 2 retrograde anchors and a locking palmar Krakow suture fixed with a button. Tendon-to-bone gapping was measured after cyclical loading. Ultimate load to failure was measured at the end of 500 cycles. RESULTS The AB technique resulted in significantly less gapping when compared to the other techniques. It also resulted in a significantly stronger repair compared to all the other groups with an average load to failure comparable to the native tendon-to-bone interface. CONCLUSIONS The AB repair might allow for early active postoperative motion after repair of flexor digitorum profundus avulsion injuries and tendon reconstruction procedures; however, the soft tissue effects of this multistrand technique are unknown in clinical repairs.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005383 Finger Injuries General or unspecified injuries involving the fingers. Injuries, Finger,Finger Injury,Injury, Finger
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001696 Biomechanical Phenomena The properties, processes, and behavior of biological systems under the action of mechanical forces. Biomechanics,Kinematics,Biomechanic Phenomena,Mechanobiological Phenomena,Biomechanic,Biomechanic Phenomenas,Phenomena, Biomechanic,Phenomena, Biomechanical,Phenomena, Mechanobiological,Phenomenas, Biomechanic
D013536 Suture Techniques Techniques for securing together the edges of a wound, with loops of thread or similar materials (SUTURES). Suture Technics,Suture Technic,Suture Technique,Technic, Suture,Technics, Suture,Technique, Suture,Techniques, Suture
D013708 Tendon Injuries Injuries to the fibrous cords of connective tissue which attach muscles to bones or other structures. Injuries, Tendon,Injury, Tendon,Tendon Injury
D013710 Tendons Fibrous bands or cords of CONNECTIVE TISSUE at the ends of SKELETAL MUSCLE FIBERS that serve to attach the MUSCLES to bones and other structures. Endotenon,Epotenon,Tendons, Para-Articular,Tendons, Paraarticular,Endotenons,Epotenons,Para-Articular Tendon,Para-Articular Tendons,Paraarticular Tendon,Paraarticular Tendons,Tendon,Tendon, Para-Articular,Tendon, Paraarticular,Tendons, Para Articular
D053441 Suture Anchors Implants used in arthroscopic surgery and other orthopedic procedures to attach soft tissue to bone. One end of a suture is tied to soft tissue and the other end to the implant. The anchors are made of a variety of materials including titanium, stainless steel, or absorbable polymers. Bone Anchors,Anchor, Bone,Anchor, Suture,Anchors, Bone,Anchors, Suture,Bone Anchor,Suture Anchor
D066298 In Vitro Techniques Methods to study reactions or processes taking place in an artificial environment outside the living organism. In Vitro Test,In Vitro Testing,In Vitro Tests,In Vitro as Topic,In Vitro,In Vitro Technique,In Vitro Testings,Technique, In Vitro,Techniques, In Vitro,Test, In Vitro,Testing, In Vitro,Testings, In Vitro,Tests, In Vitro,Vitro Testing, In

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