Mechael Rivlin - MD, Orthopedic Research Center, Mashhad University of Medical Sciences, Ghaem Hospital
Kyle R.Eberlin - MD, Orthopedic Research Center, Mashhad University of Medical Sciences, Ghaem Hospital
Amir Reza Kachooei - MD, Orthopedic Research Center, Mashhad University of Medical Sciences, Ghaem Hospital
Ali Hosseini - PhD,jj Orthopedic Research Center, Mashhad University of Medical Sciences, Ghaem Hospital

BackhroundsWe hypothesized that a side-to-side (STS) tendon repair has biomechanicalcharacteristics that match those of a Pulvertaft (PT) weave.MethodsThirty extensor tendons were harvested (4 extensor digitorum communis and 1extensor indicis proprius from 6 cadaver arms). Three hand surgery fellows withsimilar backgrounds of training under the same conditions and precise standardizedtechnique performed the repairs (5 PT and 5 STS per surgeon). After the repairs,the tendons were passed through a graft-sizing guide to determine bulk and resultswere expressed as a repaired versus native diameter ratio. The specimens were thentested for ultimate strength and fatigue properties. Failure type and mechanicalproperties were recorded and compared with those of the native tendon.ResultsThe average peak force to failure was 20 ± 93 N for the STS and 32 ± 62 N for PT group.Relative strength ratio (repair strength compared with native tendon strength) was%21 ± %37 for the STS and %11 ± %22 for the PT group. In the STS group, all failuresoccurred as a result of tissue failure; however, in the PT, suture failures occurred in 3tendons before tissue failure. The mean bulk ratio of the repaired site versus nativeproximal tendon was %14 ± 37 and %22 ± %40 more for the STS and PT groups,respectively. These values for native distal tendon were %9.9 ± %28 and 24± %26 %, respectively for STS and PT repair. Furthermore, the bulk of the repaired site for theSTS and PT groups was 0.50 ± 4.2 and 1.2 ± 4.7 mm, respectively.ConclusionsSide-to-side repair technique showed superior biomechanical properties whiledemonstrating comparable repair bulk of the tendon coaptation compared with thePulvertaft weave.