Work of Flexion Related to Different Suture Materials After Flexor Digitorum Profundus and Flexor Digitorum Superficialis Tendon Repair in Zone II: A Biomechanical Study

2009 ◽  
Vol 34 (4) ◽  
pp. 700-704 ◽  
Author(s):  
Michael D. Hwang ◽  
Sarah Pettrone ◽  
Thomas E. Trumble
Keyword(s):  
Tendon Repair ◽  
Biomechanical Study ◽  
Flexor Digitorum Profundus ◽  
Flexor Digitorum Superficialis ◽  
Suture Materials ◽  
Zone Ii ◽  
Flexor Digitorum

Flexor digitorum profundus with or without flexor digitorum superficialis tendon repair in acute Zone 2B injuries

2020 ◽  
Vol 45 (10) ◽  
pp. 1034-1044
Author(s):  
Ahmed F. Sadek
Keyword(s):  
Tendon Repair ◽  
Flexion Contracture ◽  
Flexor Digitorum Profundus ◽  
Flexor Digitorum Superficialis ◽  
Level Of Evidence ◽  
Power Grip ◽  
Contralateral Hand ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

A total of 53 patients with complete cuts of two flexor tendons in Zone 2B treated over a 9-year period was reviewed. Twenty-three patients (28 fingers) had only flexor digitorum profundus repair, while 30 patients (36 fingers) had both flexor digitorum profundus and flexor digitorum superficialis repairs, with a mean follow-up of 21 months (range 12–84). The decision to repair the flexor digitorum superficialis was made according to intraoperative judgement of ease of repair and gliding of the flexor digitorum profundus tendon. Two groups of patients showed no significant differences in total range of active or passive digital motion and power grip percentage to the contralateral hand. However, the values of power grip were statistically superior in the patients with both tendons repaired. The patients after flexor digitorum profundus-only repairs showed significantly greater but still mild flexion contracture (mean 20 °) of the operated digits. The Tang gradings were the same with 89% good and excellent rates in both groups. The conclusion is that although repair of both flexor digitorum profundus and flexor digitorum superficialis tendons is slightly more preferable based on increased grip strength, the repair of the flexor digitorum superficialis together with flexor digitorum profundus is not mandatory. Whether or not to repair flexor digitorum superficialis is an intraoperative decision based on the ease of gliding of the repaired tendon(s). Level of evidence: III

Isolated flexor digitorum profundus tendon injuries in zones IIA and IIB repaired with figure of eight sutures

2010 ◽  
Vol 36 (2) ◽  
pp. 147-153 ◽  
Author(s):  
M. M. Al-Qattan
Keyword(s):  
Tendon Repair ◽  
Suture Technique ◽  
Tendon Injuries ◽  
Flexor Digitorum Profundus ◽  
Major Disadvantage ◽  
Zone Ii ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon ◽  
Tendon Laceration

The ‘figure of eight’ suture technique for flexor tendon repair is known to be simple and strong but it has the major disadvantage of being bulky, with the knots outside the repair site. When the superficialis tendon is intact it may cause impingement and/or increase the work of flexion with postoperative mobilization and it is not known whether this bulky repair is suitable for isolated profundus injuries in zone II. A series of 36 patients (36 fingers) with clean-cut isolated flexor digitorum profundus tendon injuries in zones IIA/IIB were reviewed retrospectively. Repairs were done with three ‘figure of eight’ sutures and the pulleys proximal to the tendon laceration level were vented. Postoperatively, early active exercises were carried out. There were no ruptures. At a mean final follow-up of 6 months, the outcome (in range of motion) was excellent in 27 fingers and good in the remaining nine fingers by the Strickland criteria. It was concluded that the bulky ‘figure of eight’ technique can be used in isolated profundus tendon injuries in zones IIA/IIB.

Biomechanical investigation of ‘figure of 8’ flexor tendon repair techniques

2016 ◽  
Vol 41 (8) ◽  
pp. 815-821 ◽  
Author(s):  
A. K. Agrawal ◽  
I. S. Mat Jais ◽  
E. M. Chew ◽  
A. K. T. Yam ◽  
S. C. Tay
Keyword(s):  
Tendon Repair ◽  
Biomechanical Study ◽  
Flexor Digitorum Profundus ◽  
Modified Technique ◽  
Flexor Tendon Repair ◽  
Group 4 ◽  
Biomechanical Investigation ◽  
Active Mobilization ◽  
Flexor Digitorum ◽  
Repair Techniques

This biomechanical study compared the original Al-Qattan repair with other modifications postulated to reduce bulk and friction, thereby potentially improving outcome. A total of 32 cadaveric digits with intact flexor apparatus were used. In each digit, the flexor digitorum profundus and flexor digitorum superficialis tendons were cut cleanly in Zone 2. We tested Al-Qattan’s technique along with three modifications using stronger suture material and varying the number of strands across the repair site. Of the four repair techniques, the modified Al-Qattan’s technique using two ‘figure of 8’ 4-0 Fiberwire core sutures (Group 4) had the best balance of ultimate tensile strength (50.9 N), 2 mm gapping force (38 N) and friction. The modified technique provided a stronger repair for early active mobilization and has less friction than the originally described repair.

CLINICAL RESULTS OF EARLY ACTIVE MOBILISATION AFTER FLEXOR TENDON REPAIR

Hand Surgery ◽  
2008 ◽  
Vol 13 (01) ◽  
pp. 45-50 ◽  
Author(s):  
C. H. Yen ◽  
W. L. Chan ◽  
J. W. C. Wong ◽  
K. H. Mak
Keyword(s):  
Grip Strength ◽  
Tendon Repair ◽  
Clinical Results ◽  
Flexor Digitorum Profundus ◽  
Pinch Strength ◽  
Paired Samples ◽  
Full Flexion ◽  
Zone Ii ◽  
Flexor Digitorum

Between 2005 and 2006, ten patients with flexor digitorum profundus zone II injuries were included. The mean age was 41 (19–84) years. One thumb, two index, four middle, one ring and two little fingers were injured. Repair method comprised four-strand core suture and 6-0 circumferential sutures. Post-operative rehabilitation included immediate active extension, progressive passive full flexion and active hold in dorsal block splint. Follow-up was four (three to seven) months. Grip strength, pinch strength, ROM was 90% (70%–90%), 90% (60%–110%) and 90% (80%–100%) of normal digit, respectively. Mayo wrist scores were five excellent, two good and three fair. All patients were satisfied. Compared with another group of ten patients with the same suture method and Kleinert splintage, grip strength, pinch strength and ROM were 50%, 40% and 40% of normal side, respectively. All differences between these two groups were statistically significant (p < 0.01) by paired samples T-test. There was no re-rupture.

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