Flexor tendon repair in zone 2 using a six-strand 'figure of eight' suture.
The tensile strength of three different flexor tendon repair techniques were tested in vitro: the modified Kessler technique (a two-strand repair), two 'figure of eight' sutures (a four-strand repair) and three 'figure of eight' sutures (a six-strand repair). The mean breaking forces for the three techniques were 48.0 N, 73.1 N and 93.3 N, respectively, and the differences were highly significant (p < 0.0001). In a prospective clinical study, a total of 45 patients (50 fingers) with clean-cut complete lacerations of both flexor tendons in zone 2 were included. The protocol used the three 'figure of eight' suture techniques for (profundus only) tendon repair, 'venting' of the pulleys, and post-operative immediate active range of motion that ensured full active extension of the proximal interphalangeal joint. One repair (2%) ruptured. In the remaining 49 repairs, the result was considered excellent in 39 (78%) and good in 10 (20%) using the Strickland and Glogovac grading system.
Al-Qattan
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Department of Surgery, King Saud University, Riyadh, Saudi Arabia. moqattan@hotmail.com
Al-Turaiki
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D000293:Adolescent; D000328:Adult; D000818:Animals; D005260:Female; D005383:Finger Injuries / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D022125:Lacerations / Q000601:surgery; D008297:Male; D008875:Middle Aged; D023421:Models, Animal; D019637:Orthopedic Procedures / Q000379:methods*; D012756:Sheep; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*; D013710:Tendons / Q000601:surgery*; D013718:Tensile Strength; D055815:Young Adult