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Related Experiment Videos

Optimization of the MGH repair using an algorithm for tenorrhaphy evaluation

R J Wassermann1, R Howard, B Markee

  • 1Division of Plastic Surgery, University of South Florida, Tampa, USA.

Plastic and Reconstructive Surgery
|May 1, 1997
PubMed
Summary

The modified Becker (MGH) tendon repair is stronger and tougher than the Kessler technique in human cadavers. Its optimal two-cross configuration enhances resistance to gap formation, making it a superior choice for zone II flexor tendon repair.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Hand Surgery

Background:

  • Previous studies highlighted the MGH four-strand technique's strength and toughness.
  • The MGH technique showed no adverse effects on healing or weakening during tendon softening in rabbit models.

Purpose of the Study:

  • To compare the biomechanical performance of the modified Becker (MGH) and modified Kessler tendon repair techniques.
  • To evaluate strength, toughness, glide efficiency, and operator variability in a dynamic human cadaver model.
  • To determine the optimal configuration of the MGH tenorrhaphy for zone II flexor digitorum profundus repairs.

Main Methods:

  • 42 zone II flexor digitorum profundus repairs were performed by three surgeons on 14 human cadaver hands.
  • Biomechanical testing assessed strength, toughness, and glide efficiency of MGH versus Kessler repairs.

Related Experiment Videos

  • 51 MGH repairs on explanted tendons evaluated gap resistance with varying cross configurations (0-4 crosses per side).

    • Main Results:

    • MGH repairs were significantly stronger (79 N vs 64 N) and tougher (0.092 J vs 0.078 J) than Kessler repairs (p < 0.01).
    • Glide efficiency was comparable between the two techniques (32% vs 33%, p > 0.9).
    • Strength of Kessler repairs was operator-dependent (p < 0.005), unlike MGH repairs.
    • The MGH two-cross configuration demonstrated the highest resistance to gap formation (39 N, p < 0.05).

    Conclusions:

    • The augmented Becker (MGH) repair is biomechanically superior to the modified Kessler repair for zone II flexor tendon injuries.
    • The MGH technique offers greater strength and toughness without compromising glide efficiency and is not operator-dependent.
    • A two-cross configuration is optimal for the MGH repair, providing the best resistance to gap formation.