Effect of partial versus complete circumferential repair on flexor tendon strength in cadavers.
OBJECTIVE
This study investigated the strength of epitendinous repairs covering the palmar half of the tendon circumference only.


METHODS
Two hundred porcine tendons were harvested from pig feet and separated into 2 equal groups. Group 1 tendons were sutured with a 2-strand core repair and group 2 tendons were sutured with a 4-strand core repair. Each group was then divided into 5 equal subgroups (n=20). Four of the subgroups were sutured with 1 of the following epitendinous repairs: 50% simple running (50SR), complete simple running (100SR), 50% Silfverskiold (50SK), or complete Silfverskiold (100SK). One sub-group (0C) had no epitendinous repair. The core suture material was 3-0 braided polyester (Tricon; Tyco Healthcare, Dominican Republic), and the circumferential suture material was 6-0 polypropylene (Prolene, Sumerville, NJ). The tendons were mechanically strained to failure, and force data were recorded.


RESULTS
The 50SR and 50SK repairs significantly increased the force at 1-mm and 2-mm gap formation of both core repairs. The 50SR and 50SK repairs increased the ultimate force at failure of both core repairs by approximately 20%. Both 50% circumferential (50C) repairs increased repair strength at the points of initial gap formation more than at the point of ultimate force. The 50C repairs were approximately 50% as strong as the 100% circumferential (100C) repairs at 1-mm and 2-mm gap formation and approximately 70% as strong at the ultimate force of failure.


CONCLUSIONS
The 50C repairs increased the tensile strength of 2-strand and 4-strand tendon repairs in vitro. The prevention of early gapping was more significant than the increase of strength at failure.
Ansari
Umair
U
Royal North Shore Hospital, University of Sydney, Sydney, Australia.
Lawson
Richard D
RD
Peterson
Joanna L
JL
Appleyard
Richard C
RC
Tonkin
Michael A
MA
D000818:Animals; D001696:Biomechanical Phenomena; D005383:Finger Injuries / Q000503:physiopathology* / Q000601:surgery*; D006230:Hand Injuries / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D011091:Polyesters; D011126:Polypropylenes; D011183:Postoperative Complications / Q000503:physiopathology*; D012421:Rupture; D013536:Suture Techniques; D013552:Swine; D013708:Tendon Injuries / Q000503:physiopathology* / Q000601:surgery*; D013718:Tensile Strength / Q000502:physiology*; D016474:Weight-Bearing / Q000502:physiology
D011091:Polyesters; D011126:Polypropylenes