Central Slip Reconstruction With a Distally Based Flexor Digitorum Superficialis Slip: A Biomechanical Study
| Autor: | Samuel Louis Posey, Jed Ian Maslow, R. Glenn Gaston, Susan M. Odum, Nahir A. Habet, Marc Duemmler |
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| Rok vydání: | 2022 |
| Předmět: |
Orthodontics
Primary suture Sutures business.industry Strain (injury) Slip (materials science) medicine.disease Numerical digit Biomechanical Phenomena Cadaver Hand Deformities Acquired Direct repair Load to failure medicine Humans Orthopedics and Sports Medicine Surgery business Boutonniere deformity |
| Zdroj: | The Journal of Hand Surgery. 47:145-150 |
| ISSN: | 0363-5023 |
| Popis: | Purpose The ideal method of central slip reconstruction is difficult to determine due to the multitude of techniques, nonstandardized outcome reporting, and small patient series in the literature. Although most boutonniere deformities may be treated with nonsurgical measures, chronic, subacute, or open injuries may require operative intervention. To aid surgeons in the choice of the ideal central slip reconstruction method, this biomechanical study compared the 3 most common methods performed at our institution: direct repair, lateral band centralization, and distally-based flexor digitorum superficialis (FDS) slip repair. Methods A boutonniere deformity was induced in 35 fresh-frozen cadaver digits. The central slip was repaired in 9 digits using a primary suture repair, in 9 digits using a lateral band centralization technique, and in 9 digits using a distally-based FDS slip reconstruction. A control group without injury was tested in 8 digits. Following repair or reconstruction, each digit was tested for load to failure, strain, and stiffness at the repair. Results The average load to failure after central slip reconstruction was significantly greater for a distally based FDS slip method at 82.1 ± 14.6 N (95% CI, 62.2–101.9 N) than all other repair types. Although the FDS slip reconstruction was not as strong as the intact state (82.1 N vs 156.2 N, respectively), it was 2.6 times stronger than the lateral band centralization (82.1 N vs 31.6 N, respectively) and 3 times stronger than a primary repair (82.1 N vs 27.6 N, respectively). Conclusions Reconstruction of the central slip using a distally-based FDS slip provided the greatest biomechanical strength compared with the direct repair or lateral band centralization. Clinical relevance The use of a distally based reconstruction using FDS may allow for safer early motion. |
| Databáze: | OpenAIRE |
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