Utilizzo di splint digitali ad H per la sutura dei tendini flessori

Background. The aim of this paper was to present a new technique, the H- shaped splint, for digital flexor tendon repair, aimed at enhancing the biomechanical properties of such repairs as related to resistance to both gap formation and repair failure. Methods. In order to evaluate the gap-formation and failure strengths of the described technique, the tensiometric properties of the H-shaped splint have been compared with those of the conventional Kessler repair. The comparison was specifically limited to an in vitro biomechanical study of forces required to produce gap formation and rupture immediately following repair of fresh human flexor tendons. Results. Comparing (in an ex vivo study) the tensiometric properties of 12 flexor digitorum profundus tendons repaired with the described technique and the conventional Kessler repair (24 repairs), it has been observed that the former provided a significantly stronger repair than the latter in vitro. A statistically significant difference (p<0.001) has been found between the new technique and the Kessler repair. The 'H-splint' repair was found to increase the load at which a visible gap formed and the failure loads (ultimate strength) by 158.5% and 333.1%, respectively, when compared with the Kessler suture. The mean gap strength of the 'H-splint' repair was 137 N, whereas its mean breaking load was 62.8. Conclusions. Even if this technique will need further long-term clinical studies, the successful results obtained are statistically significant.