The Effect of an Additional Core Suture During Pulvertaft Tendon Repair: A Fresh-Frozen Cadaver Study

Abstract

Pulvertaft tendon repair is a strong suture technique; however, proper tendon tension is impaired by repair site elongation. Therefore, methods to reduce postoperative elongation are warranted. This study aimed to determine the effects of additional core sutures during Pulvertaft tendon repair on repair site elongation and rupture strength. A total of 48 finger extensor tendons were harvested from fresh-frozen cadavers, and tendons with similar diameters were paired. The 24 pairs of tendons were divided into the following 4 groups: group I, 3 interlaced weaves only; group II, 3 interlaced weaves and 2 core suture strands with 4-0 nylon; group III, 3 interlaced weaves and 2 core suture strands with 4-0 FiberWire; and group IV, 4 interlaced weaves only. Each sutured tendon was placed in a Universal Testing Machine, and repair site elongation after repeated traction loads and rupture strength were measured. The mean elongation values were 2.74 ± 0.84 mm, 1.80 ± 0.16 mm, 1.60 ± 0.18 mm, and 1.92 ± 0.18 mm for groups I, II, III, and IV, respectively. The elongation values were significantly lower in groups II, III, and IV than in group I. The mean rupture strengths were 64.9 ± 16.0 N, 94.8 ± 17.2 N, 110.9 ± 21.3 N, and 104.9 ± 17.5 N for groups I, II, III, and IV, respectively. Rupture strengths were significantly higher for groups III and IV than for group I. After adding core sutures during Pulvertaft tendon repair, the elongation amount decreased, and the rupture strength improved. The study showed the effect of additional core sutures during Pulvertaft tendon repair, suggesting that it could be useful in reducing postoperative tendon elongation when extensor tendon transfers are performed.