Abstract
Recent studies conclude that a new technique for tendon transfers, the side-to-side tenorrhaphy by Fridén (FR) provides higher biomechanical stability than the established standard first described by Pulvertaft (PT). The aim of this study was to optimize side-to-side tenorrhaphies. We compared PT and FR tenorrhaphies as well as a potential improvement, termed Woven-Fridén tenorrhaphy (WF), with regard to biomechanical stability. Our results demonstrate superior biomechanical stability and lower bulk of FR and, in particular, WF over PT tenorrhaphies. The WF and FR technnique therefore seem to be a notable alternative to the established standard tenorrhaphy as they display lower bulk and higher stability, permitting successful immediate active mobilization after surgery.
Highlights
Tendon transfers with a subsequent side-to-side tenorrhaphy are predominantly used to restore limb-function after trauma of the central or peripheral nervous system and/or trauma impairing muscle function of the extremities [1, 2]
Repair stiffness, load at first failure and ultimate failure load of the FR suture were significantly higher when compared to PT sutures [7, 8, 12, 13]
When analyzing different tenorrhaphy techniques, the WF group had the lowest relative crosssectional area, which was significantly lower when compared to the PT group (p < 0.001) (Fig 3)
Summary
Tendon transfers with a subsequent side-to-side tenorrhaphy are predominantly used to restore limb-function after trauma of the central or peripheral nervous system and/or trauma impairing muscle (tendon) function of the extremities [1, 2]. This surgical technique is commonly performed in foot and ankle as well as in hand and plastic surgery. Side-to-side tenorrhaphies are used to restore critical grasping motions of the hand after brachial plexus palsy [5, 6].
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