Gliding resistance after FDP and FDS tendon repair in zone II: an in vitro study

Many suture techniques have been described for flexor tendon repair. While many of these sutures have been tested and used clinically, the interaction between repairs of the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) in the same digit has not been rigorously examined. Moreover, while much data are available on the mechanical properties of various suture techniques for FDP repair, much less is known about the mechanical performance of FDS repairs during motion of tendons. To make up for this lack of information, we measured the gliding resistance of the repaired FDP tendon, as compared to different FDS tendon repairs in a human cadaver model. The FDP tendon was repaired with a modified Kessler technique, while the FDS was repaired with a modified Kessler (n = 10), Becker (n = 10), or a new double running zig-zag suture (n = 10). The modified Kessler repair had a threefold increase from normal gliding resistance, the Becker repair increased twofold, and the zig-zag repair increased twofold. The peak gliding resistance increased twofold with a modified Kessler repair, 2.5-fold with a Becker repair, and 2.5-fold with a zig-zag repair.