Gliding resistance after repair of partially lacerated human flexor digitorum profundus tendon in vitro.
OBJECTIVE
This study reports the gliding resistance between repaired, partially lacerated tendon and pulley in human cadaver digits, using several commonly employed repair techniques.


BACKGROUND
Suture techniques with multi-strands and locking loops have been recommended to reduce the risk of rupture of the repair tendon with early active motion. Such sutures may increase the gliding resistance, and the gliding resistance after tendon repair is also an important factor influencing the rehabilitation.


METHODS
105 specimens of second, third, or fourth fingers from 36 adult human hands were tested for the gliding resistance between flexor digitorum profundus tendon and A2 pulley in the normal condition. After an 80% laceration, each tendon was repaired with one of the following suture techniques: (1) Kessler; (2) modified Kessler; (3) Savage; (4) Lee; (5) Tsuge; and (6) Becker. All suture techniques were reinforced with a circumferential epitenon simple running suture. After tendon repair, the gliding resistance was remeasured.


RESULTS
The gliding resistance of the Becker repair was significantly greater than each of the other four repairs (P<0.05). The resistance of the modified Kessler repair was significantly less than that of the Kessler, Savage, or Tsuge repairs.


CONCLUSIONS
We conclude that the type of tendon repair can significantly affect the gliding resistance between the tendon and pulley system after tendon repair.


CONCLUSIONS
The design of the tendon repair, through its effect on friction, may have an adverse effect on the clinical results of tendon mobilization.
Zhao
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Orthopaedic Biomechanical Laboratory, Division of Orthopedic Research, Mayo Clinic/Mayo Foundation, 200 First Street S.W., Gligg 1-128, Rochester, MN 55905, USA.
Amadio
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Zobitz
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ME
Momose
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T
Couvreur
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P
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D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D017276:Friction; D006801:Humans; D022125:Lacerations / Q000601:surgery*; D008875:Middle Aged; D013536:Suture Techniques; D013708:Tendon Injuries / Q000503:physiopathology*; D013710:Tendons / Q000503:physiopathology* / Q000601:surgery