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BMC Musculoskeletal Disorders

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Open Access 01-12-2022 | Research

Dynamic Tendon Grip (DTG™) novel knot array compared to traditional sutures for zone two flexor tendon injury – a biomechanical feasibility study

Authors: Assaf Kadar, Alon Fainzack, Mordechai Vigler

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

Abstract

Background

Flexor tendon injuries pose many challenges for the treating surgeon, the principal of which is creating a strong enough repair to allow early active motion, preserving a low-profile of the repair to prevent buckling and subsequent pulley venting. A main concern is that a low-profile repair is prone to gap formation and repair failure. The Dynamic Tendon Grip (DTG™) all suture staple device claims to allow a strong and low-profile repair of the flexor tendon. The purpose of this study is to test the effects of the DTG™ device in early active motion simulation on range of motion, load to failure and gap formation and to compare it to traditional suturing technique.

Methods

Twelve fresh-frozen cadaveric fingers were assigned to two groups: DTG™ device (n = 9) and traditional suturing (double Kessler 4-core suture and a peripheral suture, n = 3). The deep flexor was incised and repaired in zone 2, and active motion simulation was carried out with a cyclic flexion–extension machine. Finger range of motion and gap formation were measured, as well as load to failure and method of repair failure.

Results

Following motion simulation, ROM decreased from 244.0 ± 9.9° to 234.5 ± 5.8° for the DTG™ device compared to 234.67 ± 6.51° to 211.67 ± 10.50° for traditional suturing. The DTG™ repair demonstrated gap formation of 0.93 ± 0.18 mm in 3 of 8 specimens after applying 1 kg load, which negated after load removal. Load to failure averaged 76.51 ± 23.15 N for DTG™ and 66.31 ± 40.22 N for the traditional repair. Repair failure occurred as the suture material broke for the DTG™ array and at the knot level for the traditional repair.

Conclusions

The DTG™ all-suture stapling concept achieved a strong low-profile repair in zone 2 flexor tendon injury after active motion simulation. Further clinical studies will be needed to determine the effectiveness of this device compared to traditional techniques.

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Title: Dynamic Tendon Grip (DTG™) novel knot array compared to traditional sutures for zone two flexor tendon injury – a biomechanical feasibility study
Authors: Assaf Kadar
Alon Fainzack
Mordechai Vigler
Publication date: 01-12-2022
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-022-05279-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Dynamic Tendon Grip (DTG™) novel knot array compared to traditional sutures for zone two flexor tendon injury – a biomechanical feasibility study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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