The Effect of the Epitendinous Suture on Gliding in a Cadaveric Model of Zone II Flexor Tendon Repair.
OBJECTIVE
We hypothesized that increasing core sutures (4-6) may be preferable in terms of gliding coefficient (GC) measurements when compared with adding an epitendinous suture to zone II flexor tendon repairs. We hypothesized that the inclusion of epitendinous suture in 2 standard repairs would contribute negatively to the GC of the repaired tendon.


METHODS
Nineteen fresh-frozen cadaveric fingers were used for testing. We compared a control group (dissected digits without repair) and 4-strand or 6-strand core tendon repairs with and without epitendinous suture. Arc of motion was driven by direct loading, and digital images were acquired and analyzed. Outcomes were defined as the difference in GC between the native uninjured and the repaired state at each load. A linear mixed-model analysis was performed with comparisons between repairs to evaluate the statistically relevant differences between groups.


RESULTS
The test of fixed effects in the linear model revealed that repair type and the use of epitendinous suture significantly affected the change in GC. The addition of an epitendinous suture produced a significant decrement in gliding regardless of repair type.


CONCLUSIONS
There was significant improvement in GC with the omission of the epitendinous suture in both repair types (4- or 6-strand).


CONCLUSIONS
The epitendinous suture used in this model resulted in poorer gliding of the repair, which may correspond with an expected increase in catching or triggering.
Department of Orthopaedic Surgery, Division of Hand and Shoulder and Elbow Surgery, University of Rochester, Rochester, NY.
Zaneb
Z
Yaseen
Department of Orthopaedic Surgery, Division of Hand and Shoulder and Elbow Surgery, University of Rochester, Rochester, NY.
Christopher
C
English
Department of Orthopaedic Surgery, Division of Hand and Shoulder and Elbow Surgery, University of Rochester, Rochester, NY.
Spencer J
SJ
Stanbury
Department of Orthopaedic Surgery, Division of Hand and Shoulder and Elbow Surgery, University of Rochester, Rochester, NY.
Tony
T
Chen
Department of Orthopaedic Surgery, Division of Hand and Shoulder and Elbow Surgery, University of Rochester, Rochester, NY.
Susan
S
Messing
Department of Orthopaedic Surgery, Division of Hand and Shoulder and Elbow Surgery, University of Rochester, Rochester, NY.
Hani
H
Awad
Department of Orthopaedic Surgery, Division of Hand and Shoulder and Elbow Surgery, University of Rochester, Rochester, NY. Electronic address: openelfar@gmail.com.
John C
JC
Elfar
D001696:Biomechanical Phenomena; D002102:Cadaver; D005385:Fingers / Q000601:surgery*; D006801:Humans; D013536:Suture Techniques; D013537:Sutures; D013708:Tendon Injuries / Q000601:surgery*
Epitendinous suture; gliding coefficient; zone II flexor tendon repair