Kessler, Strickland, or modified Becker repairs, all augmented with a runni
ng circumferential epitenon suture, were performed for simulated zone II fl
exor tendon lacerations in the index, long, and ring fingers of 12 fresh-fr
ozen cadaveric specimens. Each hand was tested with a tensiometer built for
curvilinear testing of human flexor tendons in an intact hand. Each tendon
was cycled 100 times, then examined for gapping before testing to failure.
Maximum load to failure, including tendon load and pinch force, was record
ed for each tendon. We propose that combining the advantages of cyclical te
sting and a curvilinear model is the most effective way of testing flexor t
endon repairs capable of undergoing an early active motion protocol. None o
f the repaired tendons failed during the cyclic portion of testing. The ave
rage gapping after cycling for the 3 suture techniques was 0.12 +/- 0.35 mm
for the Kessler technique, 0.00 +/- 0.00 mm for the Strickland technique,
and 0.19 +/- 0.26 mm for the modified Becker technique. The maximum tendon
loads to failure were 33.8 +/- 6.8 N for the Kessler technique, 30.4 +/- 5.
64 N for the Strickland technique, and 76.3 +/- 9.02 N for the modified Bec
ker technique. There was a statistically significant difference between the
modified Becker repair and the other 2 repa irs for maximum tendon load an
d pinch force to failure. The results of th is study show that a Il 3 tendo
n repair techniques can withstand forces reported with passive motion, but
only the modified Becker repair allows sufficient strength above those forc
es that are estimated for active motion during tendon healing. Copyright (C
) 2000 by the American Society for Surgery of the Hand.