DOI: 10.1093/bjs/znad258.067 ISSN:

4 A Quantitative Image Analysis Study of Modified Kessler Extensor Repair

A Kathiravelupillai, C Smith, R Pearl
  • Surgery

Abstract

Aim

The aims of this study were to compare and measure the amount of 4.0 Prolene suture material at the tendon repair site with 2 types of knot placement in a modified Kessler technique, as placement of suture knot can impact extensor tendon healing.

Method

Thirty-two extensor tendons of 2 fresh frozen cadaveric hands were divided and repaired using the modified Kessler technique with either intratendinous or extratendinous knot placement of a 4.0 Prolene suture. Tendon repairs were sectioned, and cross-sectional photographs were analysed using quantitative image analysis.

Results

Comparison of percentage change in tendon dimension surface area showed no significant difference (p = 0.4750) between intratendinous and extratendinous knot placement to demonstrate consistency of repair. Quantitative image analysis revealed suture material occupied a significantly (p = 0.0103) larger percentage of tendon cross sectional area in intratendinous than extratendinous knot placement. In both groups this represented <10% of the total cross-sectional area of the tendon at the repair site (7.49% vs 2.92%). There was no significant relation between digit, tendon or repair zone and percentage of repair zone occupied by suture material.

Conclusions

Intratendinous knot placement occupies a larger proportion of tendon cross sectional area than extratendinous knot placement, though this is still comparatively small when a 4’0 monofilament suture is used.

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