Online citations, reference lists, and bibliographies.
← Back to Search

Gliding Resistance After Epitendinous-First Repair Of Flexor Digitorum Profundus in Zone II.

M. Galvez, G. Comer, Arhana Chattopadhyay, C. Long, A. Behn, J. Chang
Published 2017 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
Share
PURPOSE The importance of flexor tendon repair with both core and epitendinous suture placement has been well established. The objective of this study was to determine whether suture placement order affects gliding resistance and bunching in flexor digitorum profundus tendons in a human ex vivo model. METHODS The flexor digitorum profundus tendons of the index, middle, ring, and little fingers of paired cadaver forearms were tested intact for excursion and mean gliding resistance in flexion and extension across the A2 pulley. Tendons were subsequently transected and repaired with either an epitendinous-first (n = 12) or a control (n = 12) repair. Gliding resistance of pair-matched tendons were analyzed at cycle 1 and during the steady state of tendon motion. The tendon repair breaking strength was also measured. RESULTS The mean steady state gliding resistance was less for the epitendinous-first repair than for the control repair in flexion (0.61 N vs 0.72 N) and significantly less in extension (0.68 N vs 0.85 N). Similar results were seen for cycle 1. None of the repairs demonstrated gap formation; however, control repairs exhibited increased bunching. Load to failure was similar for both groups. CONCLUSIONS The order of suture placement for flexor tendon repair is important. Epitendinous-first repair significantly decreased mean gliding resistance, allowed for easier placement of core sutures, and resulted in decreased bunching. CLINICAL RELEVANCE Epitendinous-first flexor tendon repairs may contribute to improved clinical outcomes compared with control repairs by decreasing gliding resistance and bunching.
This paper references
10.1016/j.jhsa.2012.05.018
The effects of oblique or transverse partial excision of the A2 pulley on gliding resistance during cyclic motion following zone II flexor digitorum profundus repair in a cadaveric model.
T. Moriya (2012)
10.1016/S0266-7681(05)80113-5
Flexor Tendon-Pulley Interaction afterTendon Repair
J. H. Coert (1995)
10.1016/S0363-5023(96)80299-1
Relationship between joint motion and flexor tendon force in the canine forelimb.
R. Lieber (1996)
10.1097/00003086-199207000-00025
Advantages of "epitenon first" suture placement technique in flexor tendon repair.
W. E. Sanders (1992)
10.1016/j.jhsa.2015.03.006
The Effect of the Epitendinous Suture on Gliding in a Cadaveric Model of Zone II Flexor Tendon Repair.
Z. Yaseen (2015)
10.1016/J.JHSA.2004.04.014
The effect of partial A2 pulley excision on gliding resistance and pulley strength in vitro.
T. Tanaka (2004)
10.1016/j.jhsa.2009.12.025
The effect of epitendinous suture technique on gliding resistance during cyclic motion after flexor tendon repair: a cadaveric study.
T. Moriya (2010)
10.1016/S0363-5023(05)80021-8
Biomechanical and clinical evaluation of the epitenon-first technique of flexor tendon repair.
R. Papandrea (1995)
10.1016/S0363-5023(96)80106-7
Effect of peripheral suture depth on strength of tendon repairs.
E. Diao (1996)
10.1016/j.jhsa.2009.06.028
Biomechanical comparison of techniques to reduce the bulk of lacerated flexor tendon ends within digital sheaths of the porcine forelimb.
M. Vigler (2009)
10.2106/00004623-199702000-00009
Gliding Resistance of Extrasynovial and Intrasynovial Tendons through the A2 Pulley*
S. Uchiyama (1997)
10.1016/0363-5023(92)90408-H
Flexor tendon forces: in vivo measurements.
F. Schuind (1992)
10.1016/S0266-7681(05)80240-2
Factors Affecting the Strength of Flexor Tendon Repair
D. Bhatia (1992)
10.1016/J.JHSA.2003.09.003
Adhesion formation after flexor tendon repair: a histologic and biomechanical comparison of 2- and 4-strand repairs in a chicken model.
M. J. Strick (2004)
10.1053/JHSU.2003.50074
The effect of increased peripheral suture purchase on the strength of flexor tendon repairs.
G. Merrell (2003)
10.1002/jor.22108
Intrasynovial flexor tendon repair: A biomechanical study of variations in suture application in human cadavera
G. N. Nelson (2012)
10.2106/00004623-199907000-00010
The effect of gap formation at the repair site on the strength and excursion of intrasynovial flexor tendons. An experimental study on the early stages of tendon-healing in dogs.
R. Gelberman (1999)
10.1016/j.jhsa.2011.11.006
Complications after flexor tendon repair: a systematic review and meta-analysis.
C. Dy (2012)
10.2106/00004623-199702000-00008
Boundary Lubrication between the Tendon and the Pulley in the Finger*
S. Uchiyama (1997)
10.1016/j.cps.2014.03.009
Evidence-based flexor tendon repair.
I. M. Mehling (2014)
10.1016/j.jhsa.2008.09.020
Gliding resistance and strength of composite sutures in human flexor digitorum profundus tendon repair: an in vitro biomechanical study.
J. M. Silva (2009)
10.1016/0266-7681(89)90135-6
Flexor tendon repair: significant gain in strength from the Halsted peripheral suture technique.
P. F. Wade (1989)
10.1016/j.jhsa.2014.06.025
Flexor tendon repairs: techniques, eponyms, and evidence.
A. Chauhan (2014)
10.1016/S0736-0266(00)00055-3
Gliding characteristics of tendon repair in canine flexor digitorum profundus tendons
C. Zhao (2001)
10.1016/S0266-7681(05)80113-5
Flexor tendon-pulley interaction after tendon repair. A biomechanical study.
J. Coert (1995)



This paper is referenced by
Semantic Scholar Logo Some data provided by SemanticScholar