- Discussion:
- in the case of FDP laceration, if cut is less than 1 cm from insertion, consider tendon advancement and reinsertion;
- raise osteo-periosteal flap in distal phalanx, which is just distal to volar plate;
- damage to the volar plate may lead to DIP flexion contracture;
- in contrast, overly distal tendon insertion will also result in flexion contracture;
- pass 3-0 prolene through distal edge of tendon in a Bunnel weave pattern;
- drill a small hole through the middle of the distal phalanx which exit thru the mid aspect of nail (through sterile matrix);
- using Keith needle, pass these both suture arms through the drill hole;
- tie the prolene over felt and a button;
- multiple strand repairs are stronger than single strand repairs;
- suture anchors:
- as noted by Silva, et al (1998), suture anchors had significant weakness as compared to the dorsally placed button;
- post operatively, the prolene can be pulled out after tendon healing has occurred
The effects of multiple-strand suture techniques on the tensile properties of repair of the flexor digitorum profundus tendon to bone.