Flexor tendon repairs: techniques, eponyms, and evidence

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Hand Surgery

Background:

• Surgical techniques and suture technologies offer diverse options for flexor tendon repair.
• Numerous biomechanical studies exist, yet no definitive "gold standard" surgical technique has been established.
• Surgeons often select flexor tendon repairs based on training familiarity, popularity, and perceived technical difficulty.

Purpose of the Study:

• To review and compare common flexor tendon repair techniques.
• To provide clarity on the nomenclature, technical aspects, and supporting data for various flexor tendon repairs.
• To assist surgeons in navigating the complex landscape of flexor tendon repair options.

Main Methods:

• Literature review of biomechanical studies on flexor tendon repairs.
• Analysis of suture properties, technical modifications, and repair configurations.
• Discussion of advantages, disadvantages, and technical aspects of common repair methods.

Main Results:

• The abundance of research makes identifying an optimal repair algorithm difficult.
• Common flexor tendon repairs are often chosen based on surgeon preference and experience rather than a universally agreed-upon best method.
• Detailed discussion of specific repair techniques, their historical nomenclature, and supporting evidence is presented.

Conclusions:

• A clear consensus on the optimal flexor tendon repair algorithm is lacking.
• Understanding the nuances of different repair techniques is crucial for informed surgical decision-making.
• This review aims to consolidate information on flexor tendon repairs to aid clinical practice.