title: The mechanical strength of side-to-side tendon repair with mismatched tendon size and shape.
abstract: Tendon transfers frequently require coaptation of two mismatched tendons. In this cadaver study, ultimate load, stiffness, and Young's modulus were measured in tendon-to-tendon attachments with mismatched donor and recipient tendons, using pronator teres (PT) to extensor carpi radialis brevis (ECRB) and flexor carpi ulnaris (FCU) to extensor digitorum communis (EDC). FCU-to-EDC attachments failed at higher loads than PT-to-ECRB attachments, but they had similar modulus and stiffness values. Ultimate tensile strength of the tendon attachments exceeded the maximum predicted contraction force of any of the transferred muscles, with safety factors of four-fold for the FCU-to-EDC and two-fold for the PT-to-ECRB transfers. This implies that size and shape mismatches should not be contraindications to tendon attachment in transfers. The strength safety factors suggest that postoperative immobilization of these transfers is unnecessary.
authors.affiliation: Department of Hand Surgery, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Fridén
authors.affiliation: Department of Orthopedic Surgery, University of California San Diego, San Diego, CA, USA Research Service, VA San Diego Healthcare System, San Diego, CA, USA.
authors.forename: T F
authors.initials: TF
authors.lastname: Tirrell
authors.affiliation: Department of Orthopedic Surgery, University of California San Diego, San Diego, CA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Bhola
authors.affiliation: Department of Orthopedic Surgery, University of California San Diego, San Diego, CA, USA Department of Bioengineering, University of California San Diego, San Diego, CA, USA rlieber@ucsd.edu.
authors.forename: R L
authors.initials: RL
authors.lastname: Lieber
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D013536:Suture Techniques; D013537:Sutures; D013708:Tendon Injuries / Q000601:surgery*; D013709:Tendon Transfer / Q000379:methods; D013718:Tensile Strength
keywords: Tendon transfer; stiffness; ultimate tensile strength