Elongation in profundus tendon repair. A clinical and radiological study

A radiographical study of 63 digits with tendon lacerations within the digital sheath is presented. 60 of these digits were evaluated clinically 6-36 months (mean 15 months) after surgery. At primary tendon repair one wire marker was placed on each side of the repair site in the profundus tendon. The distance between the markers was measured at operation and postoperatively on 3 different occasions on radiograms. The results showed that increase of the distance between the markers by more than 5 mm, considered to indicate elongation in the suture, occurred in 25 out of 59 repaired profundus tendons (42%) and in most instances this happened during the period of immobilization. The cause of elongation could be identified in 9 digits. In 5 it was due to rupture of the suture material, the tendons being repaired with 5-0 Flexon steel wire. In the other 4 digits, sutured with 4-0 Silky Polydec, slipping of the knot was revealed at reoperation. There was a strong correlation between increased distance between the markers and a poor outcome, elongation being the most frequent cause.