New dynamic suture material for tendon transfer surgeries in the upper extremity - a biomechanical comparative analysis.

Pastor, Tatjana; Zderic, Ivan; Dhillon, Mehar; Gueorguiev, Boyko; Richards, R Geoff; Pastor, Torsten; Vögelin, Esther (2024). New dynamic suture material for tendon transfer surgeries in the upper extremity - a biomechanical comparative analysis. Archives of orthopaedic and trauma surgery, 144(6), pp. 2905-2914. Springer 10.1007/s00402-024-05322-5

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BACKGROUND

Early mobilization after tendon surgery is crucial to avoid commonly observed postoperative soft tissue adhesions. Recently, a new suture was introduced (DYNACORD; DC) with a salt-infused silicone core designed to minimize laxity and preserve consistent tissue approximation in order to avoid gap formation and allow early mobilization.

AIMS

To compare the biomechanical competence of DC against a conventional high strength suture (FiberWire; FW) in a human cadaveric tendon transfer model with an early rehabilitation protocol.

METHODS

Sixteen tendon transfers (flexor digitorum superficialis (FDS) IV to flexor pollicis longus (FPL)) were performed in 8 pairs human cadaveric forearms using either DC or FW. Markings were set 0.8 cm proximally and 0.7 cm distally to the level of the interweaving zone of the transfer. All specimens underwent repetitive thumb flexion against resistance in 9 intermittent series of 300 cycles each, simulating an aggressive postoperative rehabilitation protocol. After each series, the distance of the proximal marker to the interweaving zone (proximal), the length of the interweaving zone (intermediate) and the distance of the distal marker to the interweaving zone (distal) were measured.

RESULTS

Pooled data over all nine series, normalized to the immediate postoperative status, demonstrated no significant differences between FW and DC (p ≥ 0.355) for the proximal and distal markers. However, at the intermediate zone, DC was associated with significant length shortening (p < 0.001) compared to FW without significant length changes (p = 0.351). Load to catastrophic failure demonstrated significant higher forces in FW (p = 0.011). Nevertheless, due to failure mainly proximal or distal of the transfer zone, these loads are not informative.

CONCLUSION

From a biomechanical perspective, DC preserved tissue approximation and might be considered as a valid alternative to conventional high-strength sutures in tendon transfer surgery. DC might allow for a shorter interweaving zone and a more aggressive early postoperative rehabilitation program, possibly avoiding commonly observed postoperative soft tissue adhesions and stiffness.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Hand Surgery

UniBE Contributor:

Pastor, Tatjana, Vögelin, Esther

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1434-3916

Publisher:

Springer

Language:

English

Submitter:

Pubmed Import

Date Deposited:

02 May 2024 09:15

Last Modified:

29 Jun 2024 00:14

Publisher DOI:

10.1007/s00402-024-05322-5

PubMed ID:

38693291

Uncontrolled Keywords:

Biomechanics Dynacord Early rehabilitation FiberWire Tendon approximation Tendon transfer

BORIS DOI:

10.48350/196444

URI:

https://boris.unibe.ch/id/eprint/196444

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