Strength, bulk and surgery time of ex situ versus in situ flexor tendon repair in a cadaveric model

J Hand Surg Eur Vol. 2023 Feb;48(2):137-143. doi: 10.1177/17531934221131376. Epub 2022 Oct 24.

Abstract

The purpose of this study was to compare strength, bulk and time of repair of human cadaveric flexor digitorum profundus tendons repaired in situ versus ex situ. Ninety-six human cadaveric flexor digitorum profundus tendons were transected 5 mm distal to the A2-pulley and randomized to 2-strand, 4-strand or 6-strand repairs. We found no significant differences in repair strength between in situ and ex situ repairs, but repair strength increased with increasing number of strands. The cross-sectional area of the repair was not significantly related to the number of strands, but 4- and 6-strand in situ repairs were bulkier than ex situ repairs. In situ repair took longer, and repair time increased with increasing number of strands. We suggest that cadaveric studies of flexor tendon repair should be performed in situ in order to better mimic the clinical reality of tissue handling and repair bulkiness.

Keywords: Flexor tendon injury; flexor tendon repair.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Biomechanical Phenomena
  • Cadaver
  • Hand / surgery
  • Humans
  • Suture Techniques
  • Sutures
  • Tendon Injuries* / surgery
  • Tendons / surgery
  • Tensile Strength