Flexor digitorum profundus tendon-to-bone repair: an ex vivo biomechanical analysis of 3 pullout suture techniques

The Journal of Hand Surgery
M J SilvaR H Gelberman

Abstract

Avulsions or distal transsections of the flexor digitorum profundus tendon are typically repaired by direct suture of tendon to the distal phalanx. The tensile properties of tendon-tobone repairs performed in cadaver fingers using 3 common suture patterns, the Bunnell, the Kessler, and the Kleinert techniques, were compared; 3-0 Prolene (monofilament) suture was used. Repairs done using the Kessler pattern had an average yield force of 30 N, compared to 39 N for the Bunnell and Kleinert patterns. Although these average yield forces were greater than that required for active digital flexion, considerable elongation (average, 8 mm) was measured at a force of 20 N. Data indicated that the safety factor achieved with these repair methods is lower than that achieved with modern tendon-to-tendon repair methods. The authors conclude that the common tendon-to-bone repair techniques are insufficient to withstand the higher forces associated with controlled passive and active motion rehabilitation methods that are currently advocated.

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Citations

Jan 16, 2014·Journal of Hand and Microsurgery·Jerrod J FelderJohn J Elias
May 11, 2005·Hand Clinics·Martin I Boyer
Jan 24, 2006·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·F B SchreuderW R Walsh
Jun 1, 2002·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Matthew J SilvaRichard H Gelberman
Aug 7, 2002·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·I GrantP J Mahaffey
Mar 8, 2006·Techniques in Hand & Upper Extremity Surgery·M J MeunierM I Boyer
May 20, 2014·Chirurgie de la main·A ForliF Moutet
Sep 18, 2014·The Journal of Hand Surgery·Ravinder BrarJonathan E Isaacs
May 16, 2013·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·S HuqD E Boyce
Jan 9, 2009·The Journal of Hand Surgery, European Volume·A K TripathiE Katsarma
Jun 18, 1999·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·D GuinardF Moutet
Jul 25, 2006·The American Journal of Sports Medicine·George A PalettaRick W Wright
Nov 24, 1999·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·M J SilvaR H Gelberman
Jul 10, 2019·The Journal of Hand Surgery, European Volume·Jose Ballesteros-BetancourtManuel Llusá-Pérez
Aug 31, 2012·Journal of Plastic Surgery and Hand Surgery·István Z RigóMagne Røkkum
Mar 4, 2011·The Journal of the American Academy of Orthopaedic Surgeons·David E RuchelsmanMichael E Rettig
Apr 1, 2021·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Samuel M ChristenPatrick S Harenberg
Jul 26, 2005·The Journal of Hand Surgery·Tom M Lawrence, Tim R C Davis
Feb 14, 2006·The Journal of Hand Surgery·Wren V McCallisterThomas E Trumble
Feb 11, 2004·Journal of Hand Therapy : Official Journal of the American Society of Hand Therapists·Gail N Groth
May 14, 2005·Journal of Hand Therapy : Official Journal of the American Society of Hand Therapists·Roslyn B Evans
Aug 30, 2011·The Journal of Hand Surgery·Steve K LeeDimitrios Christoforou
Dec 30, 2021·Hand : Official Journal of the American Association for Hand Surgery·Patrick S HarenbergSamuel M Christen

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The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand
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