A Biomechanical Comparison of Four Extensor Tendon Repair Techniques in Zone IV

Journal of the Korean Society for Surgery of the Hand 2001;6(1):7-13.
Published online January 1, 2001.

Sang Hyun Woo, Tsu-Min Tsai, Harold E. Kleinert

신전건 제 IV 구역에서 네가지 건 봉합방법에 따른 생체역학 비교

우상현, Tsu-Min Tsai, Harold E. Kleinert

Abstract

This study was designed to investigate the biomechanical factors of four different extensor tendon repair techniques using a servohydraulic frame. These four repair techniques included a modified Kessler, a figure-of-eight, a modified Becker, and a six-strand double-loop method. Fresh frozen cadaver hands were used by sharply severing the extensor tendons in zone IV and performing each of the above repairs. The time to perform each repair as well as the force to 2 mm gap formation and ultimate tensile strength were recorded. The figure-of-eight and modified Kessler repairs were statistically significantly faster than the other two repairs. The modified Becker’s technique was significantly stronger than the other repairs in initial gapping(28.8 newton). The modified Becker and modified Kessler techniques were significantly stronger than the other repairs in ultimate tensile strength(63.3 newton, 56.8 newton, respectively). The modes of failure were suture pull-out in the figure-of-eight repairs and suture breakage in the modified Becker repairs. The other repairs had varied modes of failure. Overall, the modified Becker’s technique provided the strongest repair in this study.