La sutura "wrap-core" per la riparazione di lesioni dei tendini flessori digitali

The aim of this paper was to present modifications of the conventional Kessler technique, the "wrap-core" suture, for digital flexor tendon repair, aimed at enhancing the biomechanical properties of such repairs as related to resistance to both gap formation and repair failure. Comparing (in an ex vivo study) the tensiometric properties (gap-formation and failure strengths) of 12 flexor digitorum profundus tendons repaired with the described technique (12 repairs) and the conventional Kessler repair (24 repairs), we found that the former provided a significantly stronger repair than the latter in vitro. A statistically significant difference (p<0.001) has been found between the modified techniques and the Kessler repair. The "wrap-core" suture was found to increase the load at which a visible (1 mm) gap formed by 22.6; when compared with the modified Kessler suture. The mean gap strength of the "wrap-core" repair was 6.5 N, while that of the modified Kessler 5.3 N. The failure loads (ultimate strength) of the "wrap-core" suture were observed to be 33.8% higher than those of the modified Kessler. The mean breaking load of the "wrap-core" repair was 19.4 N, while that of the modified Kessler was 14.5 N.