Effects of tenorraphy on the gliding function and tensile properties of partially lacerated canine digital flexor tendons.

Management of a partially lacerated digital flexor tendon within zone II remains controversial. To address this issue, we undertook an evaluation of the impact of tenorrhaphy on the gliding function and tensile properties of canine flexor tendons with lacerations involving either 30% or 70% of their cross-sectional area. Assessment of tendon excursion and joint rotation after 6 weeks of postoperative controlled passive mobilization failed to reveal any statistically significant benefit from tenorrhaphy on the gliding function. In fact, we demonstrated a significant negative effect of repair on tendons with 30% lacerations. Moreover, no significant differences between the structural properties or integrity of the repaired and nonrepaired tendons could be demonstrated. Thus, in light of the inherent tensile properties in these partially lacerated tendons, our data suggest that digital function of partially lacerated tendons of up to 70% of the cross-sectional area may be preserved without primary repair. However, additional work is needed to more definitively address this issue in a clinical context.

The effects of proximal load on the excursion of autogenous flexor tendon grafts.

To determine the relationship between the intrinsic properties of tendon and tendon excursion in 2 types of autogenous tendon grafts, hindpaw intrasynovial and extrasynovial tendons were transferred to the lateral and medial forepaws of adult mongrel dogs (16 experimental and 16 control tendons). After each digit was marked with radiopaque markers, it was placed in a specialized jig, and weights of 25 g, 100 g, or 200 g were applied to the flexor tendons. Specialized radiographs were obtained with the digit in flexion and extension. Tendon excursion and joint rotation were calculated. There were no statistically significant differences between experimental groups for tendon excursion or for joint angular rotation (p > .05). For intrasynovial tendon grafts, the angular rotation per millimeter tendon excursion was 10.9 degrees +/- 2.4 degrees/mm, 9.4 degrees +/- 1.2 degrees/mm, and 9.0 degrees +/- 1.4 degrees/mm with 25-g, 100-g, and 200-g loads, respectively. Comparisons between experimental groups revealed that a statistically significant difference could not be determined (p > .05). With varying proximal loads, both intrasynovial and extrasynovial grafts showed similar amounts of tendon excursion. Variations in proximal load did not significantly influence the amount of excursion within the range of loads tested. Based on these data, it appears that the difference in repair potential for these 2 types of tendon grafts is not related to a differential in the amount of tendon graft excursion following transfer to the synovial space.