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J Hand Surg Eur Vol. 2015 Mar;40(3):239-45. doi: 10.1177/1753193413517327. Epub 2014 Jan 10.

The mechanical strength of side-to-side tendon repair with mismatched tendon size and shape.

Author information

1
Department of Hand Surgery, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
2
Department of Orthopedic Surgery, University of California San Diego, San Diego, CA, USA Research Service, VA San Diego Healthcare System, San Diego, CA, USA.
3
Department of Orthopedic Surgery, University of California San Diego, San Diego, CA, USA.
4
Department of Orthopedic Surgery, University of California San Diego, San Diego, CA, USA Department of Bioengineering, University of California San Diego, San Diego, CA, USA rlieber@ucsd.edu.

Abstract

Tendon transfers frequently require coaptation of two mismatched tendons. In this cadaver study, ultimate load, stiffness, and Young's modulus were measured in tendon-to-tendon attachments with mismatched donor and recipient tendons, using pronator teres (PT) to extensor carpi radialis brevis (ECRB) and flexor carpi ulnaris (FCU) to extensor digitorum communis (EDC). FCU-to-EDC attachments failed at higher loads than PT-to-ECRB attachments, but they had similar modulus and stiffness values. Ultimate tensile strength of the tendon attachments exceeded the maximum predicted contraction force of any of the transferred muscles, with safety factors of four-fold for the FCU-to-EDC and two-fold for the PT-to-ECRB transfers. This implies that size and shape mismatches should not be contraindications to tendon attachment in transfers. The strength safety factors suggest that postoperative immobilization of these transfers is unnecessary.

KEYWORDS:

Tendon transfer; stiffness; ultimate tensile strength

PMID:
24413573
PMCID:
PMC4366193
DOI:
10.1177/1753193413517327
[Indexed for MEDLINE]
Free PMC Article

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