Prise en charge des lésions du tendon fléchisseur profond des doigts en zone 1

Forli, Alexandra; Corcella, D.; Semere, Alessandro; Mesquida, V.; Moutet, F.

doi:10.1016/j.main.2014.03.002

Cited by 4 publications

(1 citation statement)

References 54 publications

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“…33 Other contraindications for the use of bone implants are elderly patients (>75 years), osteoporosis, infections, or a concomitant fracture of the distal phalanx. 34,35 Nevertheless, from the biomechanical point of view, recent bone anchor systems seem to be superior to traditional repair methods. 12,36 In biomechanical testing, bone anchors revealed an UFL and a 2GF of up to 115 and 59 N, respectively, 12 while the highest UFL for pull-out sutures reported in the literature are 73.5 N. 37 Data about biomechanical properties of internal transosseous suture techniques however are scarce and the measured parameters are often not standardized.…”

Section: Discussionmentioning

confidence: 99%

The Transosseous Internal Four Strand Technique: A New All-Inside Technique for Zone 1 Flexor Tendon Repairs

Harenberg

Grünert

Christen

2021

Hand (New York, N,Y.)

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Background: Multiple techniques for the repair of flexor tendon injuries in zone 1 have been proposed over time. While pull-out suture techniques and bone anchor seem to be stronger than internal suture techniques, they are associated with a higher complication rate. We therefore developed an alternative internal suture repair with similar biomechanical stability to those of pull-out sutures and bone anchors. Methods: Twenty porcine distal phalanges and deep flexor tendons were randomized to 2 groups of 10 each. The tendons were transsected at the level of the distal interphalangeal joint. In group 1, repairs were performed with a well-established intraosseous suture repair and in group 2 with our new multistrand technique. The repairs were biomechanically tested with linear distraction until failure. Results: We recorded a significantly higher 2-mm gap force (2GF)—and thus higher stability—of the repairs in group 1 in comparison to group 2. With a 2GF of more than 50 N, our suture technique allows for a modern early active motion rehabilitation protocol. Breakage of the suture construct occurred at random places in the repair in both groups. No pull-outs were noted. Conclusions: This study presents a strong transosseous multistrand repair technique for flexor tendon repair in zone 1 that is simple and fast to perform and should have enough strength to withstand early active motion rehabilitation.

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