Intraosseous and extraosseous attachments of flexor tendon to bone: a biomechanical in vivo study in rabbits.
There are 2 popular methods of repairing flexor tendons to the distal phalanx and attaching a free tendon graft to bone: intraosseous, by implanting the tendon into a bony tunnel, and extraosseous, by suturing the tendon to the cortical surface after elevating the periosteum. An in vivo study was designed to determine whether one method is stronger than the other. The profundus flexor of the third and fourth toes of the hind paw of adult rabbits was divided and reattached to the middle phalanx using either an intraosseous tunnel or an extraosseous suture. Half the rabbits were killed after 3 weeks, the other half after 8 weeks. Repairs were then tested to failure, using an Instron device, and compared with the same tendons in the nonoperated limbs. The repaired tendons demonstrated similar strength 3 weeks and 8 weeks after surgery but were significantly weaker than the nonoperated tendons. The importance of this study is that it gives equal credence to these usual methods of tendon attachment.
Green
Steven M
SM
New York University Medical School, New York, New York, USA. stevengreenmd@aol.com
Posner
Martin A
MA
D000704:Analysis of Variance; D000818:Animals; D001696:Biomechanical Phenomena; D011817:Rabbits; D013536:Suture Techniques; D013537:Sutures; D013708:Tendon Injuries / Q000601:surgery*; D013710:Tendons / Q000601:surgery*; D050277:Toe Phalanges / Q000601:surgery*