Tensile properties of suture methods for repair of partially lacerated human flexor tendon in vitro

The decision to treat zone II partially lacerated flexor tendons is challen ging, because there can be justification for either repair or no repair, de pending on the surgeon's assessment of the strength of the residual intact portion of the tendon. In this study tensile properties of various repair t echniques were compared. Cadaveric human flexor tendons (n = 118) were lace rated to 75% of their cross-section and repaired with either a core suture method (Kessler, modified Kessler, Savage, Lee, augmented Becker, or Tsuge all finished with a circumferential running suture), an epitendinous suture alone (circumferential or partial), or the tendons were left unrepaired. A mong the core suture methods there was no significant difference (p > .05) in maximum failure force (overall mean, 211.2 N; SD, 53.2) or force to prod uce a 1.5-mm gap (74.1 N; SD, 49.7). Likewise there was no significant diff erence (p > .05) in tendon stiffness (41.0 N/mm; SID, 14.0) or resistance t o gap formation (52.3 N/mm; SID, 23.1). In comparison, repairs without the core suture, including unrepaired tendons, were significantly weaker (144.7 N, p < .001) and had a marginally lower stiffness (p = .04) but had a simi lar resistance to gap formation (43.5 N/mm). Copyright (C) 2001 by the Amer ican Society for Surgery of the Hand.