Supplementary core sutures increase resistance to gapping for flexor digitorum profundus tendon to bone surface repair - an in vitro biomechanical analysis.
We evaluated the effects of two types of supplementary core sutures on the tensile properties and resistance to gap formation of flexor digitorum profundus (FDP) tendon-bone repairs. Forty-five human cadaver FDP tendons were sharply released from their insertion sites and repaired to bone utilizing one of three repair techniques: four-strand modified Becker core suture (Becker only), modified Becker plus a figure-of-eight supplementary core suture (Becker plus figure-of-eight), and modified Becker plus a supplementary core suture using a bone anchor (Becker plus anchor). Ultimate (maximum) force did not differ between repair groups. However, addition of a supplementary suture significantly increased repair-site stiffness and the 1, 2 and 3 mm gap forces, while decreasing the gap at 20 N compared to the Becker only suture (P<0.05). The only difference between the two supplementary suture groups was that the Becker plus anchor group had increased stiffness compared to the Becker plus figure-of-eight group. In conclusion, a supplementary figure-of-eight suture and a supplementary suture using a bone anchor provide enhanced resistance to gap formation for FDP tendon-bone repairs.
Kusano
N
N
Department of Orthopaedic Surgery, Barnes-Jewish Hospital at Washington University, St. Louis, Missouri 63110, USA.
Zaegel
M A
MA
Placzek
J D
JD
Gelberman
R H
RH
Silva
M J
MJ
D000328:Adult; D001696:Biomechanical Phenomena; D001842:Bone and Bones / Q000601:surgery; D002102:Cadaver; D004548:Elasticity; D005385:Fingers / Q000601:surgery*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D013536:Suture Techniques; D013710:Tendons / Q000601:surgery*; D013718:Tensile Strength; D014743:Videotape Recording