The effect of flexor tendon repair bulk on tendon gliding during simulatedactive motion: An in vitro comparison of two-strand and six-strand techniques

The gliding function of 2-strand (Tajima) and 6-strand (Savage) techniques of flexor tendon repair were compared in an in vitro biomechanical model. S tainless steel beads were inserted directly into the metacarpals, phalanges , and flexor digitorum profundus tendons of 22 human cadaver specimens. The FDP tendons were loaded from 5 to 25 N using a pneumatic actuator. The ang ular rotation and tendon excursion of the cadaver specimens were measured r adiographically. The gliding function of the repairs was compared with core suture only, core suture plus epitenon repair, and sheath repair. There wa s no significant difference in angular rotation or linear excursion between the 2-strand and 6-strand techniques of flexor tendon repair. The addition of the epitendinous suture to the core suture improved the angular rotatio n and linear excursion for the 2-strand technique. Although the 6-strand re pair tended to increase the repair site bulk more than the conventional 2-s trand technique, the gliding function of the repair techniques was equivale nt. Copyright (C) 2001 by the American Society for Surgery of the Hand.