C Zhao1, P C Amadio, M E Zobitz, T Momose, P Couvreur, K N An. 1. Orthopaedic Biomechanical Laboratory, Division of Orthopedic Research, Mayo Clinic/Mayo Foundation, 200 First Street S.W., Gligg 1-128, Rochester, MN 55905, USA.
Abstract
OBJECTIVE: This study reports the gliding resistance between repaired, partially lacerated tendon and pulley in human cadaver digits, using several commonly employed repair techniques. BACKGROUND: Suture techniques with multi-strands and locking loops have been recommended to reduce the risk of rupture of the repair tendon with early active motion. Such sutures may increase the gliding resistance, and the gliding resistance after tendon repair is also an important factor influencing the rehabilitation. METHOD: 105 specimens of second, third, or fourth fingers from 36 adult human hands were tested for the gliding resistance between flexor digitorum profundus tendon and A2 pulley in the normal condition. After an 80% laceration, each tendon was repaired with one of the following suture techniques: (1) Kessler; (2) modified Kessler; (3) Savage; (4) Lee; (5) Tsuge; and (6) Becker. All suture techniques were reinforced with a circumferential epitenon simple running suture. After tendon repair, the gliding resistance was remeasured. RESULTS: The gliding resistance of the Becker repair was significantly greater than each of the other four repairs (P<0.05). The resistance of the modified Kessler repair was significantly less than that of the Kessler, Savage, or Tsuge repairs. CONCLUSIONS: We conclude that the type of tendon repair can significantly affect the gliding resistance between the tendon and pulley system after tendon repair. RELEVANCE: The design of the tendon repair, through its effect on friction, may have an adverse effect on the clinical results of tendon mobilization.
OBJECTIVE: This study reports the gliding resistance between repaired, partially lacerated tendon and pulley in human cadaver digits, using several commonly employed repair techniques. BACKGROUND: Suture techniques with multi-strands and locking loops have been recommended to reduce the risk of rupture of the repair tendon with early active motion. Such sutures may increase the gliding resistance, and the gliding resistance after tendon repair is also an important factor influencing the rehabilitation. METHOD: 105 specimens of second, third, or fourth fingers from 36 adult human hands were tested for the gliding resistance between flexor digitorum profundus tendon and A2 pulley in the normal condition. After an 80% laceration, each tendon was repaired with one of the following suture techniques: (1) Kessler; (2) modified Kessler; (3) Savage; (4) Lee; (5) Tsuge; and (6) Becker. All suture techniques were reinforced with a circumferential epitenon simple running suture. After tendon repair, the gliding resistance was remeasured. RESULTS: The gliding resistance of the Becker repair was significantly greater than each of the other four repairs (P<0.05). The resistance of the modified Kessler repair was significantly less than that of the Kessler, Savage, or Tsuge repairs. CONCLUSIONS: We conclude that the type of tendon repair can significantly affect the gliding resistance between the tendon and pulley system after tendon repair. RELEVANCE: The design of the tendon repair, through its effect on friction, may have an adverse effect on the clinical results of tendon mobilization.
Authors: Michail N Kolodzinskyi; Chunfeng Zhao; Yu-Long Sun; Kai-Nan An; Andrew R Thoreson; Peter C Amadio; Steven L Moran Journal: J Hand Surg Am Date: 2013-01-05 Impact factor: 2.230
Authors: Chunfeng Zhao; Peter C Amadio; Tatsuro Tanaka; Chao Yang; Anke M Ettema; Mark E Zobitz; Kai-Nan An Journal: J Hand Ther Date: 2005 Jul-Sep Impact factor: 1.950
Authors: Jun Ikeda; Chunfeng Zhao; Qingshan Chen; Andrew R Thoreson; Kai-Nan An; Peter C Amadio Journal: J Biomech Date: 2011-05-06 Impact factor: 2.712
Authors: Manabu Taguchi; Yu-Long Sun; Chunfeng Zhao; Mark E Zobitz; Chung-Ja Cha; Gregory D Jay; Kai-Nan An; Peter C Amadio Journal: J Orthop Res Date: 2009-02 Impact factor: 3.494