Technical and Biological Modifications for Enhanced Flexor Tendon Repair

Hyun-Min Mike Kim, Gregory Nelson, Stavros Thomopoulos, Matthew J. Silva, Rosalina Das, Richard H. Gelberman

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

Clinical outcomes after intrasynovial flexor tendon repair have been substantially improved over the past 2 decades through advances in tendon suture techniques and postoperative rehabilitation methods. Nevertheless, complications such as repair site elongation (i.e., gap formation) and rupture continue to occur frequently. Experimental studies have shown that repair site strength fails to increase in the first 3 weeks after tendon suture. After 3 weeks, the strength and rigidity of the repair site improve significantly, a process that continues for several months. Formation of a repair site gap during the early rehabilitation period has been shown to considerably delay the accrual of repair site strength over time. Thus, it is of prime importance that the method of tendon suture achieves and maintains a stiff and strong repair site during the early healing interval by maintaining close approximation of the tendon stumps and by stimulating, where possible, the intrinsic repair response. In this review, we describe recent efforts to enhance the integrity of the immature repair site. We focus on 2 major areas of advancement: surgical technique modifications and manipulation of the biologic and biochemical environment.

Original languageEnglish (US)
Pages (from-to)1031-1037
Number of pages7
JournalJournal of Hand Surgery
Volume35
Issue number6
DOIs
Publication statusPublished - Jun 1 2010

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All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine
  • Surgery
  • Medicine(all)

Cite this

Kim, H-M. M., Nelson, G., Thomopoulos, S., Silva, M. J., Das, R., & Gelberman, R. H. (2010). Technical and Biological Modifications for Enhanced Flexor Tendon Repair. Journal of Hand Surgery, 35(6), 1031-1037. https://doi.org/10.1016/j.jhsa.2009.12.044