Article ; Online: All-Suture Anchor Repair of the Flexor Digitorum Profundus Insertion: A Biomechanical Comparison of 2 Suturing Techniques.
2022 Volume 48, Issue 12, Page(s) 1276.e1–1276.e7
Abstract: ... mattress; group H + K (n = 12) via horizontal mattress with knots thrown and, with each suture tail, 3 ... together. We excluded 2 specimens from the H + K group because of improper anchor placement ... We defined failure as >3-mm gapping.: Results: The H + K group had significantly less gapping during ...
| Abstract | Purpose: We compared 2 suturing techniques for reattachment of the flexor digitorum profundus (FDP) via all-suture anchor. Methods: We used fresh, matched-pair, cadaveric hands. We disarticulated the fingers at the proximal interphalangeal joints, preserving the proximal FDP. We released the FDPs at their distal insertion and placed an all-suture, 1.0-mm anchor at the center of each FDP footprint. Each anchor's sutures were used to reattach each FDP using 1 of 2 techniques: group H (n = 14) via horizontal mattress; group H + K (n = 12) via horizontal mattress with knots thrown and, with each suture tail, 3 proximal, running-locking, Krackow-type passes on the radial and ulnar FDP sides with the suture ends tied together. We excluded 2 specimens from the H + K group because of improper anchor placement. All other fingers in both groups were individually mounted in an MTS machine for FDP loading in the following sequence for 500 cycles each: (1) to 15 N to simulate passive motion forces; (2) to 19 N for short-arc active motion forces; and (3) to 28 N for full active motion forces. Specimens that had not failed during cyclic testing were then loaded to failure. We measured FDP-to-bone gapping via a digital transducer. We defined failure as >3-mm gapping. Results: The H + K group had significantly less gapping during cyclic loading up to 19 N and significantly higher load to failure. The H + K group failed exclusively at the anchor-bone level; the H group failed mostly by suture-tendon pullout. Conclusions: The H + K group performed significantly better regarding cyclic and load-to-failure testing after FDP reattachment. Clinical relevance: The H + K technique combines the benefits of horizontal-mattress tendon-to-bone apposition and Krackow-tendon locking. It converts the point of failure to the bone level rather than the suture-tendon level. |
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| MeSH term(s) | Humans ; Suture Anchors ; Tendon Injuries/surgery ; Finger Injuries/surgery ; Tendons/surgery ; Suture Techniques ; Biomechanical Phenomena ; Cadaver |
| Language | English |
| Publishing date | 2022-06-29 |
| Publishing country | United States |
| Document type | Journal Article ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 605716-0 |
| ISSN | 1531-6564 ; 0363-5023 |
| ISSN (online) | 1531-6564 |
| ISSN | 0363-5023 |
| DOI | 10.1016/j.jhsa.2022.05.003 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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