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Preliminary Clinical Results of a Novel Tendon Repair System
Charles Andrew Daly, MD; William Strawn Godfrey, BS; Michael Brandon Gottschalk, MD; Diane E Payne, MD, DPT
Emory University, Atlanta, GA
Hypothesis: Multiple flexor tendon repair systems have been produced but have largely failed to provide significant benefit over multi-strand core suture repair thus limiting widespread usage. Regardless of the repair method, flexor tendon repair continues to suffer from complications stemming from an imbalance of the equilibrium between stiffness and re-rupture. The goals of this study are to preliminarily investigate the clinical value and shortcomings of this stainless steel suture-crimp system. Our hypothesis is that this novel system demonstrates no significant difference in results as compared to core suture repair with decreased operative times.
Methods: Following institutional review board (IRB) approval the billing database for a single surgeon was queried for all Common Procedural Terminology (CPTâ) codes for tendon repair in the hand and wrist during a two-year period. Patients who did not return for their postoperative visits were excluded. This resulted in the collection of 33 patients, in 10 of which the stainless steel suture-crimp system was utilized. Demographics, comorbidities, injury characteristics, complications, suture configuration, operative time, rehabilitation protocol, and postoperative range of motion were collected. A Student’s T-test was utilized to compare the two groups.
Results: Average follow up was 113 days postoperatively. Postoperative total finger arc range of motion between the two groups was similar with a mean of 132 degrees for the core suture group and 122 degrees for the stainless steel suture-crimp group (p=0.727). There was a single re-rupture in each group. The average total operative time was 52 minutes per tendon repaired for the the core suture group and 33 minutes per tendon repaired for the stainless steel suture-crimp group (p=0.181).
Summary: There is no clinical data up to this point that the practicing physician can utilize to make a decision about the efficacy of this novel method of flexor tendon repair. Biomechanical studies have demonstrated improved strength as compared to core suture techniques[1]. This study demonstrates that there is no significant difference in short term outcomes with regard to motion, and it is possible that operative times may be decreased with use of this system, although this was not statistically significant. As a result of the increased strength of repairs with this system, it may lend itself to patients who may prove to be more demanding on their tendinous repair as a result of noncompliance. These outcomes and potential benefits indicate that this system is worthy of further long-term prospective studies to fully define its risk-benefit profile.
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