M. Brustein et al., Bone suture anchors versus the pullout button for repair of distal profundus tendon injuries: A comparison of strength in human cadaveric hands, J HAND S-AM, 26A(3), 2001, pp. 489-496
Avulsion or distal tendon laceration of flexor digitorum profundus (FDP) is
classically repaired to the base of the distal phalanx via a pullout sutur
e over a button. Bone suture anchors, used extensively in other surgical ar
eas, have recently been proposed for reattachment of the FDP to the distal
phalanx. The FDP tendons of the index, long, and ring fingers in 9 fresh fr
ozen cadaveric hands were randomized to 1 of 3 repair techniques after simu
lated distal avulsion injuries. These were the pul lout button using 3-0 mo
nofilament nylon in a 2-strand Bunnell suture pattern, the 1.8 mm Mini Quic
kAnchor (Mitek Products, Norwood, MA) using 3-0 braided polyester in a 2-st
rand Bunnell suture pattern, and the Mitek micro anchor using 3-0 braided p
olyester with a modified 4-strand Becker suture pattern. Nine specimens wer
e loaded to failure, noting maximum load and mode of failure. The 1.3 mm Mi
cro QuickAnchor (Mitek) technique (69.6 +/- 10.8 N) was significantly stron
ger than the pullout button (43.3 +/- 4.8 N) or the Mini anchor technique (
44.6 +/- 12.7 N). The Micro bone suture anchor provides a stronger tendon t
o bone repair than the pullout button or the Mini anchor. Given the disadva
ntages of the pullout button, the Micro bone suture anchor with the modifie
d Becker technique is worth consideration as an alternative method to repai
r distal FDP avulsions. Copyright (C) 2001 by the American Society for Surg
ery of the Hand.