Comparing Biomechanical Properties, Repair Times, and Value of Common Core Flexor Tendon Repairs.

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Hand Surgery

Background:

• Zone II flexor tendon injuries are common and challenging to repair.
• Optimal repair techniques aim to restore biomechanical strength and minimize repair time.
• Comparing different suture constructs is crucial for improving patient outcomes.

Purpose of the Study:

• To compare biomechanical strength, repair times, and overall repair values for various zone II core flexor tendon repair techniques.
• To evaluate the efficacy of different suture materials and configurations.

Main Methods:

• Seventy-five human cadaveric flexor tendons were used, randomized into five repair groups.
• Repairs were assessed for strength, time, and calculated repair value (including OR costs and suture costs).
• Statistical analysis (ANOVA, Tukey post hoc) was employed to compare outcomes.

Main Results:

• The 4-stranded braided cruciate repair exhibited the greatest biomechanical strength (P > .05) but was the slowest to perform (P > .05).
• The 4-stranded Pennington repair with double-stranded suture was the fastest repair technique (P > .05).
• Barbed sutures did not show superior performance in any tested category.

Conclusions:

• The braided cruciate repair is the strongest among the tested methods for zone II flexor tendons.
• Suture cost should not be a primary factor when selecting a flexor tendon repair technique.
• The braided cruciate repair's strength approached historical data for more complex repairs.