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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2018

Open Access 01-12-2018 | Research article

Reattachment of the flexor and extensor tendons at the epicondyle in elbow instability: a biomechanical comparison of techniques

Authors: Andreas Lenich, Christian Pfeifer, Philipp Proier, Roman Fleer, Coen Wijdicks, Martina Roth, Frank Martetschläger, Jonas Pogorzelski

Published in: BMC Musculoskeletal Disorders | Issue 1/2018

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Abstract

Background

Elbow dislocation represents a common injury, especially in the younger population. If treated surgically, the reattached tendons require a high amount of primary stability to allow for an early rehabilitation to avoid postoperative stiffness. The purpose of this study was to assess the biomechanical properties of a single and a double row technique for reattachment of the common extensor and common flexor muscles origin. We hypothesized that the double row technique would provide greater stability in terms of pullout forces than the single row technique.

Methods

Twelve cadaveric specimens were randomized into two groups of fixation methods for the common extensor tendon or the common flexor tendon at the elbow (1): a single row technique using two knotted 3.0 mm suture anchors, and (2) a double row technique using an additional knotless 3.5 mm anchor. The repairs were cyclically loaded over 500 cycles at 1 Hz from 10 N to a maximum of 100 N (extensors) or 150 N (flexors), and then pulled to failure. Stiffness and maximum load at failure and mode of failure were recorded and calculated.

Results

No significant differences in stiffness were observed between the two techniques for both the extensor and flexor reattachment (P = 0.701 and P = 0.306, respectively). The mean maximum load at failure indicated that the double row construct was significantly stronger than the single row construct. This was found to be true for both the extensor and flexor reattachment (213.6; SD 78.7 N versus 384.1; SD 105.6 N, P = 0.010 and 203.7; SD 65.8 N versus 318.0; SD 64.6 N, P = 0.013, respectively).

Conclusions

The double row technique provides significant greater stability to the reattached common flexor or extensor origin to the medial or lateral epicondyle. Thus, it should be considered in the development of improved repair techniques for stabilizers of the elbow.

Study design

Controlled laboratory study.
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Metadata
Title
Reattachment of the flexor and extensor tendons at the epicondyle in elbow instability: a biomechanical comparison of techniques
Authors
Andreas Lenich
Christian Pfeifer
Philipp Proier
Roman Fleer
Coen Wijdicks
Martina Roth
Frank Martetschläger
Jonas Pogorzelski
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2018
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-018-2341-y

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