Work of flexion after tendon repair with various suture methods. A human cadaveric study

After flexor tendon repair there is often increased resistance to tendon gliding at the repair site, which is greater for techniques using increased suture strands or suture material. This increased "friction" may be measured as the "work of flexion" in the laboratory setting. Tendon repairs performed in zone 2 in human cadaver hands using the two strand Kessler, the lateral Becker, the six strand Savage, internal and dorsal tendon splint, or the external mesh sleeve techniques, had "work of flexion" measurements made both before and after the laceration and repair. The average increase in work of flexion was 4.8% for Kessler; 6.5% for Becker; 10.9% for Savage; 19.3% for the internal tendon splint, 16.2% for the dorsal tendon splint and 44.3% for the external mesh sleeve. The work of flexion was found to increase in direct proportion to the amount of suture material at the repair site.