COMPARATIVE MECHANICAL ANALYSIS OF DORSAL VERSUS PALMAR PLACEMENT OF CORE SUTURE FOR FLEXOR TENDON REPAIRS

This study was designed to evaluate the effect of core suture placemen t in the coronal plane on the tensile strength of flexor tendon repair s. We compared the tensile strength of modified Kessler core sutures p laced in the palmar Versus the dorsal side of matched-lacerated human cadaver flexor digitorum profundus tendons tested in vitro under stati c loading. We also compared the relative strengths of the dorsal and p almar portions of the flexor digitorum tendons. The mean failure load of a dorsal-side modified Kessler suture was 26.5% greater than that o f a palmar-side modified Kessler suture. The mean strength of the dors al half of the flexor digitorum tendons was 58.3% greater than that of the palmar half of the flexor digitorum tendons. Our data demonstrate that the dorsal tendon can sustain greater loads-to-failure than the palmar tendon. This suggests that there are biomechanical advantages t o dorsal as opposed to palmar placement of the care suture in clinical tendon repair.