Two modified techniques for flexor tendon repair

The aim of this article is to present two new techniques for digital flexor tendon repair: a modification to the conventional Kessler technique (wrap core suture) and tendon splints (H-shaped splint). These techniques were ai med at enhancing the biomechanical properties of such repairs as related to resistance to both gap formation and repair failure. Comparing (in an ex v ivo study) the tensiometric properties (gap formation and failure strengths ) of 24 flexor digitorum profundus tendons repaired with the described tech niques (12 repairs per each technique) and the conventional Kessler repair (24 repairs), we found that the former provided significantly stronger repa irs than the latter in vitro. A statistically significant difference (p < 0 .001) was found between each of the two presented techniques and thr Kessle r repair. The wrap core suture increased the load at which a visible (1 mm) gap formed by 22.6 percent when compared with the conventional Kessler sut ure. The mean gap strength of the wrap core repair was 6.5 N, whereas that of the conventional Kessler was 5.3 N. The failure loads (ultimate strength ) of the wrap core suture were 33.8 percent higher than those of the conven tional Kessler. The mean breaking load of the wrap core repair was 19.4 N, whereas that of the conventional Kessler was 14.5 N. The H-splint repair in creased the load at which a risible gap formed and the failure loads (ultim ate strength) by 158.5 and 333.1 percent, respectively, when compared with the conventional Kessler suture. The mean gap strength of the H-splint repa ir was 13.7 N, and its mean breaking load was 62.8 N.