Abstract
The behaviour of two different methods of reattachment of the flexor digitorum profundus tendon insertion was assessed. Cyclical testing simulating the first 5 days of a passive mobilisation protocol was used to compare the micro Mitek anchor to the modified-Bunnell pull-out suture. Twelve fresh-frozen cadaveric fingers were dissected to the insertion of the FDP tendon. The FDP insertion was then sharply dissected from the distal phalanx and repaired using one of two methods: group 1 -modified Bunnell pullout suture using 3/0 Prolene; group 2 micro Mitek anchor loaded with 3/0 Ethibond inserted into the distal phalanx. Each repaired finger was mounted on to a material testing machine using pneumatic clamps. We cyclically tested the repair between 2N and 15N using a load control of 5N/s for a total of 500 cycles. Gap formation at the tendon bone interface was measured every 100 cycles.
No specimens failed during cyclical testing. After 500 cycles, gap formation of the tendon-bone interface was 6.6mm (SD = 1.2mm), and 2.1 mm (SD = 0.3mm) for the pullout technique and the micro Mitek anchor repair respectively. Concerns related to suture anchors, such as anchor failure or protrusion, joint penetration, and anchor-suture junction failure, were not encountered in this study.
Cyclical loading results suggest that the repair achieved with both methods of fixation is sufficient to avoid failure. However, significant gap formation at the tendon-bone interface in the modified Bunnell group is of concern, suggesting it may not be the ideal fixation method.
Correspondence should be addressed to the editorial secretary: Associate Professor Jean-Claude Theis, Department of Orthopaedic Surgery, Dunedin Hospital, Private Bag 1921, Dunedin, New Zealand.
