Bone suture anchors versus the pullout button for repair of distal profundus tendon injuries: A comparison of strength in human cadaveric hands

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.