Supplementary core sutures increase resistance to gapping for flexor digitorum profundus tendon to bone surface repair - an in vitro biomechanical analysis |
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Authors: | Kusano N Zaegel M A Placzek J D Gelberman R H Silva M J |
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Affiliation: | Department of Orthopaedic Surgery, Barnes-Jewish Hospital at Washington University, St. Louis, Missouri 63110, USA. |
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Abstract: | We evaluated the effects of two types of supplementary core sutures on the tensile properties and resistance to gap formation of flexor digitorum profundus (FDP) tendon-bone repairs. Forty-five human cadaver FDP tendons were sharply released from their insertion sites and repaired to bone utilizing one of three repair techniques: four-strand modified Becker core suture (Becker only), modified Becker plus a figure-of-eight supplementary core suture (Becker plus figure-of-eight), and modified Becker plus a supplementary core suture using a bone anchor (Becker plus anchor). Ultimate (maximum) force did not differ between repair groups. However, addition of a supplementary suture significantly increased repair-site stiffness and the 1, 2 and 3 mm gap forces, while decreasing the gap at 20 N compared to the Becker only suture (P<0.05). The only difference between the two supplementary suture groups was that the Becker plus anchor group had increased stiffness compared to the Becker plus figure-of-eight group. In conclusion, a supplementary figure-of-eight suture and a supplementary suture using a bone anchor provide enhanced resistance to gap formation for FDP tendon-bone repairs. |
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