PURPOSE: Gap formation is a common and severe complication after flexor tendon repair that can affect the outcome and prolong tendon healing. The purpose of this study was to investigate the effect that a pretensional force applied to the suture during tendon repair has on the repair strength and force that causes gap formation. METHODS: We used a total of 48 flexor digitorum profundus tendons from 12 human cadaver hands. We employed a core tendon suture, using the modified Pennington technique, and a running suture for flexor tendon repair. Before tying the knots of the core suture, we preloaded the sutures in each tendon end 0, 5, 10, or 15 N for 10 seconds to compare the effect of loading magnitude on repaired tendon peak force to failure and force causing gap formation. RESULTS: The force to form a gap of 2 mm in the 15-N preload group was significantly increased compared with the 0-N and 5-N preload groups. At the 3-mm gap formation, the force of all preload groups was significantly higher than the nonpreload group. The peak force with a preload of 10 N and 15 N was significantly higher than 0-N preload. CONCLUSIONS: These findings suggest that pretensioning with 10 to 15 N at the suture-tendon interface before tying the knot has a beneficial effect on both the tendon gap formation and the peak force to failure. CLINICAL RELEVANCE: When the surgeons perform tendon repair, pretensioning at the suture-tendon conjunction will increase the repair strength.
PURPOSE: Gap formation is a common and severe complication after flexor tendon repair that can affect the outcome and prolong tendon healing. The purpose of this study was to investigate the effect that a pretensional force applied to the suture during tendon repair has on the repair strength and force that causes gap formation. METHODS: We used a total of 48 flexor digitorum profundus tendons from 12 human cadaver hands. We employed a core tendon suture, using the modified Pennington technique, and a running suture for flexor tendon repair. Before tying the knots of the core suture, we preloaded the sutures in each tendon end 0, 5, 10, or 15 N for 10 seconds to compare the effect of loading magnitude on repaired tendon peak force to failure and force causing gap formation. RESULTS: The force to form a gap of 2 mm in the 15-N preload group was significantly increased compared with the 0-N and 5-N preload groups. At the 3-mm gap formation, the force of all preload groups was significantly higher than the nonpreload group. The peak force with a preload of 10 N and 15 N was significantly higher than 0-N preload. CONCLUSIONS: These findings suggest that pretensioning with 10 to 15 N at the suture-tendon interface before tying the knot has a beneficial effect on both the tendon gap formation and the peak force to failure. CLINICAL RELEVANCE: When the surgeons perform tendon repair, pretensioning at the suture-tendon conjunction will increase the repair strength.
Authors: Daniel A Osei; Jeffrey G Stepan; Ryan P Calfee; Stavros Thomopoulos; Martin I Boyer; Ryan Potter; Richard H Gelberman Journal: J Hand Surg Am Date: 2013-12-15 Impact factor: 2.230
Authors: Cormac W Joyce; Conor Sugrue; Jeffrey C Chan; Luis Delgado; Dimitrios Zeugolis; Seam M Carroll; Jack L Kelly Journal: Plast Reconstr Surg Glob Open Date: 2014-11-07
Authors: Turki A Al-Thunayan; Mohammed T Al-Zahrani; Ahmad A Hakeem; Fahad M Al-Zahrani; Mohammad M Al-Qattan Journal: Saudi Med J Date: 2016-09 Impact factor: 1.484