BIOMECHANICAL AND CLINICAL-EVALUATION OF THE EPITENON-FIRST TECHNIQUEOF FLEXOR TENDON REPAIR

Thirteen matched pairs of canine flexor tendons were repaired using bo th the Epitenon-first and the modified Kessler with an epitendinous ru nning suture. These were then tested to failure with a longitudinal fo rce in an Instron test machine. Human cadaver flexor digitorum profund us tendons were used to determine the cross sectional area of the tend on that is displaced by suture material of the Kessler repair and Epit enon-first core suture. Results of biomechanical testing revealed the epitenon-first technique to be 22% stronger than the modified Kessler technique. Comparison of tendon repair cross sectional contact areas b y digital; scanning of surface photomicrographs demonstrated 20% of th e surface area of the repair is occupied by the knot of the modified K essler technique, while the core suture of the epitenon-first repair c onsumed only 2.6% of the cross sectional area. These findings correlat e with our clinical results of 26 zone II flexor tendon repairs in 18 patients repaired with the epitenon-first technique over a 4-year peri od. Of these, there has been one rupture and no repeat operations for lysis of adhesions.