Flexor digitorum profundus tendon-to-bone repair: an ex vivo biomechanical analysis of 3 pullout suture techniques

J Hand Surg Am. 1998 Jan;23(1):120-6. doi: 10.1016/S0363-5023(98)80099-3.

Abstract

Avulsions or distal transsections of the flexor digitorum profundus tendon are typically repaired by direct suture of tendon to the distal phalanx. The tensile properties of tendon-tobone repairs performed in cadaver fingers using 3 common suture patterns, the Bunnell, the Kessler, and the Kleinert techniques, were compared; 3-0 Prolene (monofilament) suture was used. Repairs done using the Kessler pattern had an average yield force of 30 N, compared to 39 N for the Bunnell and Kleinert patterns. Although these average yield forces were greater than that required for active digital flexion, considerable elongation (average, 8 mm) was measured at a force of 20 N. Data indicated that the safety factor achieved with these repair methods is lower than that achieved with modern tendon-to-tendon repair methods. The authors conclude that the common tendon-to-bone repair techniques are insufficient to withstand the higher forces associated with controlled passive and active motion rehabilitation methods that are currently advocated.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Cadaver
  • Finger Joint / physiology
  • Finger Joint / surgery
  • Fingers / physiology
  • Fingers / surgery*
  • Humans
  • Polypropylenes
  • Random Allocation
  • Suture Techniques*
  • Sutures
  • Tendons / physiology
  • Tendons / surgery*
  • Tensile Strength

Substances

  • Polypropylenes