Title
An in vitro model of flexor profundus tendon repair in young children: comparing the tensile strengths of two figure of eight sutures to two figure of eight with simple locking sutures at the corners
Background
In young children, the size of flexor profundus tendon in zone II is 3-4 mm in diameter. For such injured pediatric tendons, Strong repairing techniques are still lacking and need further studying. Our review of the literature did not reveal any biomechanical studies of the tensile strength of repairs in those small pediatric tendons.
Aim: To develop a new stronger suturing technique and compare its tensile strength to a known technique using hind sheep flexor profundus tendons with a diameter of 3-4 mm.
Summary of Work
20 tendons were obtained from hind sheep feet and were divided in two groups. In group I (n=10 tendons), the repair was done using two figure of eight sutures utilizing 4/0 prolene sutures. In group II (n=10 tendons), the repair was similar to group I but with the addition of 4 simple locking sutures at the four corners of the repair. Both the 2-mm gap force and the breaking strength were compared between the two repair techniques using student T test.
Methods Techniques Tensometer
Summary of Results
The addition of the locking sutures significantly (p<0.05) increased both the gap force and the breaking strength.
Conclusion
The addition of locking sutures to the figure of eight sutures in the repair of flexor tendons in zone II in young children will significantly increase the strength of the repair and this means it might be of great benefit if applied clinically, however, clinical trials are needed first.
Take-home Messages
- Flexor tendon repairing techniques are of great need for development in the pediatric age group.
- The new technique has promising results and might be applied after appropriate clinical trials.
References
- Qattan MM. Flexor tendon injuries in the child. J Hand Surg Eur. 2014, 39:46-53.
- Savage R. The search for the ideal tendon repair in Zone 2: strand number, anchor points, and suture techniques. J Hand Surg Eur. 2014, 39: 20-9.
- Wu YF, Tang JB. Recent developments in flexor tendon repair techniques and factors influencing strength of the tendon repair. J Hand Surg Eur.2014, 39:6-19
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Acknowledgement
- King Saud bin Abdulaziz University for Health Sciences
- King Saud University Medical Laboratory