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Oblique Tendon Laceration Effect on Repair Strength
Claude Muresan, Coin Muresan, Alexandria Harris, Ashkaum Shaterian, Panambur Bhandari, Michelle Palazzo
Christine M. Kleinert Institute for Hand and Microsurgery
2020-01-14
Presenter: Claude Muresan
Affidavit:
I certify that Claude Muresan has not published his Oblique Tendon Laceration research project prior to this presentation and that the project represents his idea and efforts.
Director Name: Michelle Palazzo
Author Category: Fellow Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: Hand
We sought to investigate if the angle of tendon laceration effects the repair strength. The overwhelming majority of biomechanical studies in current literature assess tendon repair strength following a 90 degree laceration. Our study analyzed fresh human cadaveric tendons cut at oblique angles and repaired with a 6-Strand modified-Tang technique to see if the cut angle effected breaking strength. 110 tendons were cut at decreasing acute angles: 60, 45,30, 15 degrees and compared to a control group cut at 90 degrees. Each group of 22 tendons were repaired with a looped 3-0 Supermaid suture using a modified-Tang technique. Static gaping and breaking strength was assessed using an Asani Hanging Weight scale construct. Two tailed t-tests demonstrated significant difference between the control group and the 60 deg (P = 0.02), 45 deg (P=0.001), 30 deg (P = 0.0002), and 15 deg (P=0.0001) groups. Two tailed t-tests also demonstrated statistically significant difference between the 60 deg group and the 30 deg (P=0.03) and 15 deg (P=0.03) groups. Tendons cut at 90 deg demonstrated a higher overall breaking strength that was statistically significant when compared to all obliquely cut groups. A statistically significant difference between the 60-30 and 60-15 groups suggests that a cut angles difference of 30 degrees or greater decreases repair strength. Theses findings should be considered by surgeons when repairing obliquely cut tendons. To that effect strategies such as increasing core sutures, or epitendinous repair can be employed to strengthen repair in obliquely cut tendons
