Comparison of various tendon repair techniques in extansor zone 3 injuries: an experimental biomechanical cadaver study


ULUDAĞ A., TOSUN H. B., Celik S., SERBEST S., Kayalar M., Aytac G., ...More

ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, vol.140, no.4, pp.583-590, 2020 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 140 Issue: 4
  • Publication Date: 2020
  • Doi Number: 10.1007/s00402-020-03384-9
  • Journal Name: ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CINAHL, EMBASE, MEDLINE, SportDiscus
  • Page Numbers: pp.583-590
  • Keywords: Hand injury, Extansor, Tendon repair, Zone 3, Suture, Biomechanic, SUTURE TECHNIQUES
  • Akdeniz University Affiliated: Yes

Abstract

Purpose To compare five different repair techniques for extensor tendon zone III modified Kessler (MK), double-modified Kessler (DMK), modified Kessler epitendinous (MKE), double-modified Kessler epitendinous (DMKE), and running-interlocking horizontal mattress (RIHM) in terms of shortening, stiffness, gap formation, and ultimate load to failure. Methods A total of 35 human cadaver fingers were randomly assigned to five suture techniques with 7 fingers each and were tested under dynamic and static loading conditions. Results DMK was found to be superior over MK in terms of ultimate load to failure (36 N vs. 24 N, respectively), shortening (1.75 vs. 2.20 mm, respectively) and gap formation. However, these two methods had similar characteristics in terms of stiffness. The addition of epitendinous sutures to the repair methods resulted in approximately 40% increase in ultimate load to failure, whereas epitendinous sutures had no effect on shortening. DMKE was found to be superior over MKE in terms of shortening (1.77 vs. 2.22 mm, respectively). However, these two methods had similar characteristics in terms of mean ultimate load to failure and stiffness. RIHM was found to be superior over the other four methods in terms of ultimate load to failure (89 N), stiffness, and shortening (0.75 mm). Conclusion RIHM was found to be stronger and more durable for extensor tendon zone III than the other techniques in terms of ultimate load to failure and stiffness.