Gliding Characteristics and Gap Formation for Locking and Grasping Tendon Repairs: A Biomechanical Study in a Human Cadaver Model

Tatsuro Tanaka, Peter C. Amadio, Chunfeng Zhao, Mark E. Zobitz, Chao Yang, Kai Nan An

Research output: Contribution to journalArticlepeer-review

68 Scopus citations

Abstract

Purpose: The purpose of this study was to compare the frictional characteristics and mechanical properties of various locking and grasping suture techniques in a human in vitro model of flexor tendon repair. Methods: Forty-five cadaveric human flexor digitorum profundus tendons were transected in zone II and repaired using 1 of 5 core suture methods (n = 9 per group): either grasping (modified grasping Kessler, modified Lee) or locking (Pennington, modified Pennington, locking Lee) loop suture techniques. All repairs used 4-0 Supramid looped core suture and an epitenon running suture of 6-0 nylon. Gliding resistance at the tendon-pulley interface was measured along with failure strength and gap formation. The force to produce 0.5-, 1.0-, 1.5-, and 2.0-mm gaps were measured. Results: One of the locking repairs, the locking Lee, had a gliding resistance significantly higher than that of one of the grasping repairs (modified grasping Kessler) and the other 2 locking repairs (Pennington, modified Pennington) (p < .05). There was no significant difference between the other grasping (modified Kessler, modified Lee) and locking (Pennington, modified Pennington) suture configurations (p = .21). The maximum force of one of the locking repairs, the modified Pennington repair (48.0 N; standard deviation, 3.9) was significantly higher than the other locking and grasping repairs (p < .05). The force required to produce more than 1.5 mm of gap for the modified Pennington repair was also significantly higher than that for some of the other grasping (modified Kessler, modified Lee) and locking (Pennington) repairs (p < .05). Conclusions: The lack of significant difference in gliding resistance among the similarly designed modified grasping Kessler, Pennington, and modified Pennington repairs (overall mean, 0.87 N; standard deviation, 0.16) suggests that the locking loop configuration itself does not adversely affect tendon gliding resistance. The modified Pennington repair increased not only ultimate strength but also resistance to gap formation more than 1.5 mm.

Original languageEnglish (US)
Pages (from-to)6-14
Number of pages9
JournalJournal of Hand Surgery
Volume29
Issue number1
DOIs
StatePublished - Jan 2004

Keywords

  • Flexor tendon
  • Gliding resistance
  • Locking suture
  • Tendon repair

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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