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Related Experiment Videos

Cyclical testing of zone II flexor tendon repairs.

J Choueka1, H Heminger, D P Mass

  • 1Department of Orthopaedic Surgery, University of Chicago, Chicago, IL, USA.

The Journal of Hand Surgery
|December 20, 2000
PubMed
Summary

The modified Becker repair for flexor tendon lacerations demonstrated superior strength compared to Kessler and Strickland techniques. This repair method shows promise for early active motion protocols during tendon healing.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Hand Surgery

Background:

  • Zone II flexor tendon lacerations pose significant challenges in hand surgery.
  • Effective tendon repair is crucial for restoring function and enabling early mobilization.
  • Existing repair techniques vary in biomechanical strength and suitability for early active motion.

Purpose of the Study:

  • To compare the biomechanical properties of Kessler, Strickland, and modified Becker flexor tendon repairs.
  • To evaluate the strength and gap resistance of these repairs under simulated physiological loading conditions.
  • To determine the most suitable repair technique for facilitating early active motion protocols in flexor tendon healing.

Main Methods:

  • Simulated zone II flexor tendon lacerations were created in cadaveric hands.

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  • Three repair techniques (Kessler, Strickland, modified Becker) were performed, augmented with epitenon sutures.
  • Tendons underwent cyclic loading (100 cycles) followed by testing to failure using a tensiometer with a curvilinear model.

    • Main Results:

    • No repaired tendons failed during the cyclic loading phase.
    • The modified Becker repair exhibited significantly greater maximum load to failure and pinch force compared to Kessler and Strickland techniques.
    • Average gapping after cyclic loading was minimal for all techniques, with Strickland showing 0.00 mm.

    Conclusions:

    • All three tested flexor tendon repair techniques demonstrated adequate strength for passive motion protocols.
    • The modified Becker repair offers superior biomechanical strength, exceeding forces estimated for active motion during tendon healing.
    • The modified Becker repair is recommended for its potential to allow earlier and safer active mobilization post-surgery.