The effect of the epitendinous suture on gliding in a cadaveric model of zone II flexor tendon repair

Zaneb Yaseen, Christopher English, Spencer J. Stanbury, Tony Chen, Susan Messing, Hani Awad, John C. Elfar

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Purpose We hypothesized that increasing core sutures (4-6) may be preferable in terms of gliding coefficient (GC) measurements when compared with adding an epitendinous suture to zone II flexor tendon repairs. We hypothesized that the inclusion of epitendinous suture in 2 standard repairs would contribute negatively to the GC of the repaired tendon. Methods Nineteen fresh-frozen cadaveric fingers were used for testing. We compared a control group (dissected digits without repair) and 4-strand or 6-strand core tendon repairs with and without epitendinous suture. Arc of motion was driven by direct loading, and digital images were acquired and analyzed. Outcomes were defined as the difference in GC between the native uninjured and the repaired state at each load. A linear mixed-model analysis was performed with comparisons between repairs to evaluate the statistically relevant differences between groups. Results The test of fixed effects in the linear model revealed that repair type and the use of epitendinous suture significantly affected the change in GC. The addition of an epitendinous suture produced a significant decrement in gliding regardless of repair type. Conclusions There was significant improvement in GC with the omission of the epitendinous suture in both repair types (4- or 6-strand). Clinical relevance The epitendinous suture used in this model resulted in poorer gliding of the repair, which may correspond with an expected increase in catching or triggering.

Original languageEnglish (US)
Pages (from-to)1363-1368
Number of pages6
JournalJournal of Hand Surgery
Issue number7
StatePublished - Jul 1 2015

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine


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