Flexor tendon laceration repairs remain challenging despite numerous advances in hand surgery. Although progress on this vital subject matter has been achieved, there continues to be discussion over which surgical technique produces the optimal result. Currently there are several recommended surgical repair options for the lacerated flexor tendon. However, these repairs continue to have possible significant complications including adhesions, decreased range of motion, gapping, and post operative rupture. Stainless steel suture has long been known as an option for flexor tendon repair. Stainless steel suture demonstrates one of the highest tensile strength sutures. However until recently, stainless steel suture placement for flexor tendon repairs was technically problematic. This case study discusses an additional option for repairing lacerated flexor tendons using an advanced stainless steel tendon repair system.

During neonatal development, tendons undergo a well orchestrated process whereby extensive structural and compositional changes occur in synchrony to produce a normal tissue [1,2]. Similarly, during the repair response to injury, structural and compositional changes occur, but in this case, a mechanically inferior tendon is produced. As a result, the process of development has been postulated as a potential paradigm through which improved tissue healing may occur. By examining injury at distinctly different stages of development, we will obtain vital information into the structure-function relationships in tendon. Although the mouse is an intriguing model system due to the availability of assays and genetically altered animals, due to the small size and fragile nature of neonatal tendons, neonatal tendon injury has not been evaluated. Therefore, the objective of this study is to evaluate the differential healing response in neonatal tendon at two distinct stages of development. We hypothesized that when normalized, maximum stress and modulus will be significantly higher in early neonatal injury when compared to later neonatal injury. Also, when normalized, maximum stress, modulus and percent relaxation will be significantly increased over time in early neonatal injury but will remain low in later neonatal injury.