The influence of cross-sectional area on the tensile properties of flexor tendons

Citation
Mi. Boyer et al., The influence of cross-sectional area on the tensile properties of flexor tendons, J HAND S-AM, 26A(5), 2001, pp. 828-832
Citations number
13
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine
Journal title
JOURNAL OF HAND SURGERY-AMERICAN VOLUME
ISSN journal
0363-5023 → ACNP
Volume
26A
Issue
5
Year of publication
2001
Pages
828 - 832
Database
ISI
SICI code
0363-5023(200109)26A:5<828:TIOCAO>2.0.ZU;2-P
Abstract
Clinicians have long noted substantial variation in the cross-sectional siz e of flexor tendons in the hand; however, data indicating that surgical rep air techniques of lacerated flexor tendons should be altered according to s ize are unavailable. Our objectives were to evaluate the cross-sectional si ze differences among tendons within the same hand and to correlate tendon s ize with tensile mechanical properties after suture repair. Fifty human cad aver flexor digitorum profundus tendons were measured with digital calipers to determine radioulnar and volardorsal diameters. Twenty tendons were use d to measure resistance to suture pull-through; tendons were transected at the A2 pulley, and a transverse double-stranded 4-0 Supramid suture (S. Jac kson, Inc, Alexandria, VA) was passed through the radioulnar plane of the t endon I cm from the transection site. The remaining tendons were transected and repaired by using a modified Kessler repair with double-stranded 4-0 S upramid suture. Both tendon repairs and tendon-suture pull-through specimen s were tested to failure in tension by using a material testing machine. Do rsovolar tendon height and tendon cross-sectional area varied significantly between digits, with an average difference of approximately 40% between th e values of the smallest (fifth) and largest (third) fingers. Yield and ult imate force determined by pull-through tests of the simple transverse sutur e correlated positively with tendon radiouInar width. Tensile properties of tendons repaired with a double-stranded modified Kessler repair, however, did not depend significantly on tendon size. These results indicate that th e strength of the commonly used Kessler suture technique is not dependent o n tendon cross-sectional size within the clinically relevant range of tendo ns evaluated. Copyright (C) 2001 by the American Society for Surgery of the Hand.