Purpose
The purpose of this study was to investigate the impact of repairing a zone II flexor
digitorum profundus (FDP) laceration anatomically versus extra-anatomically on tendon
loads and work of flexion (WOF).
Methods
Twenty digits from 5 cadaveric specimens were tested using an in vitro active finger motion simulator under 2 FDP tendon repair conditions: anatomic and
extra-anatomic. Tensile loads in FDP and flexor digitorum superficialis (FDS), WOF,
and total active finger range of motion (ROM) were measured using in-line load cells
and electromagnetic tracking, respectively.
Results
The anatomic repairs had no effect on tendon loads or WOF for either FDP or FDS. The
extra-anatomic repairs increased FDP loads by 32% and decreased FDS loads by 9% compared
with those in the intact condition. This pattern was similar for WOF following extra-anatomic
repairs, which increased FDP WOF by 31% and decreased FDS WOF by 18%. Comparing the
2 repairs, FDP loads and WOF were 25% and 22% greater, respectively, with extra-anatomic
repairs compared with anatomic repairs, with no significant change in FDS. Total active
ROM was not affected by either repair.
Conclusions
In this in vitro cadaveric model, extra-anatomic repairs of FDP increased tendon loads and WOF compared
with anatomic repairs.
Clinical relevance
On the basis of this study, reconstitution of the anatomic relationship of FDP and
FDS at the Camper chiasm during the repair of zone II flexor tendon lacerations is
recommended.
Key words
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Article info
Publication history
Published online: December 23, 2021
Accepted:
October 28,
2021
Received:
March 9,
2021
Footnotes
M.M.H. and E.C.M. contributed equally to this manuscript.
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2023 by the American Society for Surgery of the Hand. All rights reserved.
