J Hand Microsurg 2013; 5(2): 54-57
DOI: 10.1007/s12593-013-0097-z
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Mechanical Properties of the Flexor Digitorum Profundus Tendon Attachment

Jerrod J. Felder
,
Loredana M. Guseila
,
Archana Saranathan
,
Timothy J. Shary
,
Steven B. Lippitt
,
John J. Elias

Subject Editor:
Further Information

Publication History

12 November 2012

23 May 2013

Publication Date:
05 September 2016 (online)

Abstract

The current study was performed to determine the strength and rigidity of the intact flexor digitorum profundus (FDP) tendon attachment and compare the rigidity at the attachment site to the rigidity within a more proximal part of the tendon. Eight cadaveric index fingers were tested to failure of the FDP tendon. Lines were drawn on each tendon with India ink stain at the position of the attachment to bone and 5 mm and 10 mm proximally. Each test was recorded using a high resolution video camera. A minimum of six images per test were used for analysis of tissue deformation. The centroid of each line was computationally identified to characterize the deformation of the tendon between the lines. Force vs. deformation curves were generated for the 5 mm region representing the tendon attachment and the 5 mm region adjacent to the attachment. Stiffness measurements were generated for each curve, and normalized by the initial length to determine the rigidity. The failure strength ranged from 263 N to 548 N, with rigidity values ranging from 2201 N/(mm/mm) to 8714 N/(mm/mm) and from 3459 N/(mm/mm) to 6414 N/(mm/mm) for the attachment and the tendon proximal to the attachment, respectively. The rigidity did not vary significantly between the attachment and proximal tendon based on a Wilcoxon signed rank test (p=0.2). The measured strength and rigidity establish biomechanical properties for the FDP tendon attachment to bone.

 
  • References

  • 1 Silva MJ, Hollstien SB, Brodt MD, Boyer MI, Tetro AM, Gelberman RH. Flexor digitorum profundus tendon-to-bone repair: An ex vivo biomechanical analysis of 3 pullout suture techniques. J Hand Surg Am 1998; 23: 120-126
  • 2 Dovan TT, Gelberman RH, Kusano N, Calcaterra M, Silva MJ. Zone I flexor digitorum profundus repair: An ex vivo biomechanical analysis of tendon to bone repair in cadavera. J Hand Surg Am 2005; 30: 258-266
  • 3 Moiemen NS, Elliot D. Primary flexor tendon repair in zone 1. J Hand Surg Br 2000; 25: 78-84
  • 4 Kusano N, Zaegel MA, Placzek JD, Gelberman RH, Silva MJ. Supplementary core sutures increase resistance to gapping for flexor digitorum profundus tendon to bone surface repair - an in vitro biomechanical analysis. J Hand Surg Br 2005; 30: 288-293
  • 5 Brustein M, Pellegrini J, Choueka J, Heminger H, Mass D. Bone suture anchors versus the pullout button for repair of distal profundus tendon injuries: A comparison of strength in human cadaveric hands. J Hand Surg Am 2001; 26: 489-496
  • 6 Latendresse K, Dona E, Scougall PJ, Schreuder FB, Puchert E, Walsh WR. Cyclic testing of pullout sutures and micro-mitek suture anchors in flexor digitorum profundus tendon distal fixation. J Hand Surg Am 2005; 30: 471-478
  • 7 Matsuzaki H, Zaegel MA, Gelberman RH, Silva MJ. Effect of suture material and bone quality on the mechanical properties of zone I flexor tendon-bone reattachment with bone anchors. J Hand Surg Am 2008; 33: 709-717
  • 8 Silva MJ, Hollstien SB, Fayazi AH, Adler P, Gelberman RH, Boyer MI. The effects of multiple-strand suture techniques on the tensile properties of repair of the flexor digitorum profundus tendon to bone. J Bone Joint Surg Am 1998; 80: 1507-1514
  • 8 Silva MJ, Thomopoulos S, Kusano N, Zaegel MA, Harwood FL, Matsuzaki H, Havlioglu N, Dovan TT, Amiel D, Gelberman RH. Early healing of flexor tendon insertion site injuries: Tunnel repair is mechanically and histologically inferior to surface repair in a canine model. J Orthop Res 2006; 24: 990-1000
  • 10 Holden CE, Northmore-Ball MD. The strength of the profundus tendon insertion. Hand 1975; 7: 238-240
  • 11 Pring DJ, Amis AA, Coombs RR. The mechanical properties of human flexor tendons in relation to artificial tendons. J Hand Surg Br 1985; 10: 331-336
  • 12 Schuind F, Garcia-Elias M, Cooney WP, An KN. Flexor tendon forces: In vivo measurements. J Hand Surg Am 1992; 17: 291-298
  • 13 Thomopoulos S, Zampiakis E, Das R, Silva MJ, Gelberman RH. The effect of muscle loading on flexor tendon-to-bone healing in a canine model. J Orthop Res 2008; 26: 1611-1617
  • 14 Cooper RR, Misol S. Tendon and ligament insertion. A light and electron microscopic study. J Bone Joint Surg Am 1970; 52: 1-20
  • 15 Miller KS, Connizzo BK, Feeney E, Soslowsky LJ. Characterizing local collagen fiber re-alignment and crimp behavior throughout mechanical testing in a mature mouse supraspinatus tendon model. J Biomech 2012; 45: 2061-2065
  • 16 Thomas SJ, Miller KS, Soslowsky LJ. The upper band of the subscapularis tendon in the rat has altered mechanical and histologic properties. J Shoulder Elbow Surg 2012; 21: 1687-1693
  • 17 Derwin KA, Soslowsky LJ, Green WD, Elder SH. A new optical system for the determination of deformations and strains: Calibration characteristics and experimental results. J Biomech 1994; 27: 1277-1285
  • 18 Tuttle HG, Olvey SP, Stern PJ. Tendon avulsion injuries of the distal phalanx. Clin Orthop Relat Res 2006; 445: 157-168
  • 19 Wright TM, Hayes WC. Tensile testing of bone over a wide range of strain rates: Effects of strain rate, microstructure and density. Med Biol Eng 1976; 14: 671-680
  • 20 Woo SL, Peterson RH, Ohland KJ, Sites TJ, Danto MI. The effects of strain rate on the properties of the medial collateral ligament in skeletally immature and mature rabbits: A biomechanical and histological study. J Orthop Res 1990; 8: 712-721
  • 21 Parimi M, Zhao C, Thoreson AR, An KN, Amadio PC. Does loading velocity affect failure strength after tendon repair?. J Biomech 2012; 45: 2939-2942
  • 22 Hashemi J, Mansouri H, Chandrashekar N, Slauterbeck JR, Hardy DM, Beynnon BD. Age, sex, body anthropometry, and ACL size predict the structural properties of the human anterior cruciate ligament. J Orthop Res 2011; 29: 993-1001
  • 23 Woo SL, Hollis JM, Adams DJ, Lyon RM, Takai S. Tensile properties of the human femur-anterior cruciate ligament-tibia complex. The effects of specimen age and orientation. Am J Sports Med 1991; 19: 217-225