Flexor Tenorrhaphy Using Absorbable Suture Materials

Abstract

BackgroundNonabsorbable sutures are favorable for repairing flexor tendons. However, absorbable sutures have performed favorably in an animal model.MethodsTwo-strand sutures using the interlocking modified Kessler method with polydioxanone absorbable sutures 4-0 were used to repair completely ruptured flexor tendons in 55 fingers from 41 consecutive patients. The medical records of average 42 follow up weeks were analyzed retrospectively. The data analyzed using the chi-squared test, and Fisher's exact test was used for postoperative complications. The results were compared with those of other studies.ResultsAmong the index, middle, ring, and little fingers were injured in 9, 17, 16, and 13 fingers, respectively. The injury levels varied from zone 1 to 5. Of the 55 digits in our study, there were 26 (47%) isolated flexor digitorum profundus (FDP) injuries and 29 (53%) combined FDP and with flexor digitorum superficialis injuries. Pulley repair was also conducted. Concomitant injuries of blood vessels and nerves were found in 17 patients (23 fingers); nerve injuries occurred in 5 patients (10 fingers). Two patients had ruptures (3.6%), and one patient had two adhesions (3.6%). Using the original Strickland criteria, all the patients were assessed to be excellent or good. Also, fibrosis and long-term foreign body tissue reactions such as stitch granuloma were less likely occurred in our study. Compared to the Cullen's report that used nonabsorbable sutures, there was no significant difference in the rupture or adhesion rates.ConclusionsTherefore, this study suggests that appropriate absorbable core sutures can be used safely for flexor tendon repairs.

A Comparative Evaluation of Absorbable and Nonabsorbable Sutures for Open Repair of Achilles Tendon Rupture: A Pilot Study

“…To overcome the aforementioned disadvantages of nonabsorbable suture materials, the use of absorbable suture materials for tendon repair have been considered in animal model [6,11,12]. Also, clinical results have been reported in flexor tenorrhaphy using absorbable suture materials [13].…”

Open Reduction of Proximal Interphalangeal Fracture-Dislocation through a Midlateral Incision Using Absorbable Suture Materials

“…Using sutures made of nonabsorbable materials may cause stitch granuloma, fibrosis, triggering, and other complications because the body responds to the foreign suture material [ 21 ]. Kang et al [ 22 ] repaired the flexor tendons using PDS on 55 fingers of 41 patients. No complications such as the aforementioned complications of nonabsorbable suture materials were detected.…”

Assessment of digital flexors tenorrhaphy in equine: a review

“…Current treatments of tendon lacerations have focused on promoting extrinsic repair, by tenorrhaphy in many repair techniques including different suture pattern, carbon fibres implants and tendon transplantation to minimize the tension placed on the injuried tissue (Foland et al 1991;Kang et al 2012). While, promoting intrinsic repair by stimulating the fibroblast like cells to migrate and/or proliferate into the injuried site, resulting in production and regeneration of new collagen matrix which gradually replaced by a new matrix with more mature collagen matrix.…”