Purpose
The purpose of the study was to evaluate joint kinematics and tendon work of flexion
(WOF) following a flexor digitorum profundus (FDP)-to-volar plate (VP) repair technique
relative to a pullout button for zone I flexor tendon injuries.
Methods
Fourteen digits were tested using an in vitro active finger motion simulator under
3 repaired conditions following a simulated zone I avulsion: button, FDP-VP, and “no
slack” FDP-VP (corrected for additional VP length). Outcome metrics included active
joint range of motion (ROM), fingertip strength, FDP and flexor digitorum superficialis
tensile loads, and WOF.
Results
The button and FDP-VP techniques restored WOF to the intact condition for FDP and
flexor digitorum superficialis. All repairs restored distal interphalangeal joint
ROM and kinematics to the intact condition. Similarly, all repairs restored WOF; however,
the “no slack” FDP-VP significantly increased WOF by 10% to 12% over the simple FDP-VP
repair. The button technique had similar fingertip strength to the intact condition,
whereas the FDP-VP repairs significantly reduced peak fingertip strength from intact,
albeit only 1–2 N compared with the button repair.
Conclusion
In this in vitro cadaveric model, the button and FDP-VP techniques restored WOF and
ROM to within intact levels, with no difference between these repairs in all measured
outcome metrics.
Clinical relevance
Based on its initial strength and its equal biomechanical performance compared with
the button repair, the FDP-VP technique may be a viable option for treating FDP avulsions.
Key words
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Article info
Publication history
Published online: October 25, 2022
Accepted:
September 7,
2022
Received:
January 13,
2022
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
