Effect of Partial Versus Complete Circumferential Repair on Flexor Tendon Strength in Cadavers

Umair Ansari, Richard D. Lawson, Joanna L. Peterson, Richard C. Appleyard, Michael A. Tonkin*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Purpose: This study investigated the strength of epitendinous repairs covering the palmar half of the tendon circumference only. Methods: Two hundred porcine tendons were harvested from pig feet and separated into 2 equal groups. Group 1 tendons were sutured with a 2-strand core repair and group 2 tendons were sutured with a 4-strand core repair. Each group was then divided into 5 equal subgroups (n=20). Four of the subgroups were sutured with 1 of the following epitendinous repairs: 50% simple running (50SR), complete simple running (100SR), 50% Silfverskiold (50SK), or complete Silfverskiold (100SK). One sub-group (0C) had no epitendinous repair. The core suture material was 3-0 braided polyester (Tricon; Tyco Healthcare, Dominican Republic), and the circumferential suture material was 6-0 polypropylene (Prolene, Sumerville, NJ). The tendons were mechanically strained to failure, and force data were recorded. Results: The 50SR and 50SK repairs significantly increased the force at 1-mm and 2-mm gap formation of both core repairs. The 50SR and 50SK repairs increased the ultimate force at failure of both core repairs by approximately 20%. Both 50% circumferential (50C) repairs increased repair strength at the points of initial gap formation more than at the point of ultimate force. The 50C repairs were approximately 50% as strong as the 100% circumferential (100C) repairs at 1-mm and 2-mm gap formation and approximately 70% as strong at the ultimate force of failure. Conclusions: The 50C repairs increased the tensile strength of 2-strand and 4-strand tendon repairs in vitro. The prevention of early gapping was more significant than the increase of strength at failure.

Original languageEnglish
Pages (from-to)1771-1776
Number of pages6
JournalJournal of Hand Surgery
Issue number10
Publication statusPublished - Dec 2009
Externally publishedYes

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