Flexor Tendon

Repair of Flexor Digitorum Profundus to Distal Phalanx: A Biomechanical Evaluation of Four Techniques

Lee SK, Fajardo M, Kardashian G, et al (Hosp for Special Surgery, NY) J Hand Surg 36A:1604-1609, 2011^§

Abstract

Purpose

Many techniques for repair of the flexor digitorum profundus to the distal phalanx show excessive gapping with variable clinical results. The purpose of this study was to test the biomechanical characteristics of an anchor-button (AB) technique, as compared to 3 other techniques.

Methods

Twenty-four fresh-frozen human cadaveric fingers were randomized to 4 groups, 6 in each: group 1, 2-strand Bunnell suture button pullout technique; group 2, modified Kessler suture and 2 retrograde anchors; group 3: locking Krakow suture with 2 retrograde anchors; group 4, AB technique incorporating a 2-part repair, consisting of a locking dorsal Krakow suture with 2 retrograde anchors and a locking palmar Krakow suture fixed with a button. Tendon-to-bone gapping was measured after cyclical loading. Ultimate load to failure was measured at the end of 500 cycles.

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