Zaneb Yaseen1, Christopher English1, Spencer J Stanbury1, Tony Chen1, Susan Messing1, Hani Awad1, John C Elfar2. 1. Department of Orthopaedic Surgery, Division of Hand and Shoulder and Elbow Surgery, University of Rochester, Rochester, NY. 2. Department of Orthopaedic Surgery, Division of Hand and Shoulder and Elbow Surgery, University of Rochester, Rochester, NY. Electronic address: openelfar@gmail.com.
Abstract
PURPOSE: 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). CLINICAL RELEVANCE: 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.
PURPOSE: 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). CLINICAL RELEVANCE: 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.