Abstract
Three methods to reattach avulsed finger flexor tendons to the distal phalanx were compared: a 1.8 mm metal barbed suture anchor, twin 1.3 mm PLA (polylactic acid)absorbable anchors, or a pull-out suture over a button. The suture-anchor interface was tested by pulling the suture at 0, 45, and 90 degrees to the anchor’s axis. The anchors were tested similarly in plastic foam bone substitute. Repairs of transected tendons in cadaveric fingers were loaded cyclically, then to failure. The suture failed prematurely if pulled across the axis of the anchor. Conversely, fixation in bone substitute was stronger when pulling at an angle from the axis. Cyclic loads caused significantly more gap formation in-vitro with twin 1.3 mm absorbable anchors than the other methods; this method was significantly weaker. The 1.8 mm anchor gave similar performance to the pull-out suture over button technique, while the twin 1.3 mm absorbable anchors were weaker and vulnerable to gap formation even with passive motion alone.
Correspondence should be addressed to Mr Carlos Wigderowitz, Senior Lecturer, University Department of Orthopaedic and Trauma Surgery, Ninewells Hospital and Medical School, Dundee DD1 9SY.
