AAHS ASPN ASRM - 2013 Annual Meeting - American Association ...

Flexor Digitorum Profundus Repair to Bone: A Biomechanical Comparison
Institution where the work was prepared: University of New Mexico, Albuquerque, NM, USA
Deana Mercer; keikhosrow firoozbakhsh; jenifer fitzpatrick; moheb moneim; University of New Mexico
Purpose:
Treatment of distal flexor digitorum profundus injuries presents a challenge to the orthopaedic surgeon. Presently available techniques for repair of flexor digitorum
profundus tendon injuries include button or suture anchor fixation. This study evaluates a newly proposed absorbable suture anchor and compares it
to techniques using non-absorbable suture anchor of comparable size and button fixation.
Methods:
Fifteen fresh-frozen cadaveric hands were used. The index, long, and ring finger were harvested for testing. Fifteen digits were randomly assigned to each of
the three fixation techniques. Tendon-to-bone repair was done using the button, absorbable suture anchor, and non-absorbable suture anchor technique.
Specimens were tested to failure using the Bionex-MTS system. Mode of failure and force to failure of fixation was recorded and statistically analyzed.
Results:
Force to failure was not significantly different among the three fixation techniques (p>0.05). The mode of failure for the button technique was suture pullout
through tendon (100%). The mode of failure for the absorbable suture anchor was rupture at the anchor-suture interface (80%) and anchor pull-out (20%).
The mode of failure for the non-absorbable suture anchor was suture pull-out through the tendon (60%) and rupture at the anchor-suture interface (40%).
Discussion:
Bone quality, bone-anchor interface, and suture material play an important role in fixation strength. An insight to the mode of failure suggests that the best
fixation technique in osteoporotic bone is the button technique or the non-absorbable suture anchor.
A New Scoring System for Assessing Severity in Dupuytren's Disease
Institution where the work was prepared: University of Manchester, Manchester, United Kingdom
Sandip Hindocha, MBChB; John K. Stanley, MCh, Orth, FRCS; Stewart J. Watson, MRCP, FRCS; Ardeshir Bayat, MD, PhD; University of Manchester
Many factors have been associated with severity in Dupuytren's disease (DD). Previous methods to assess severity of DD are based on the degree of contracture
of an affected digit. We feel these methods of assessment may be incomplete and that other factors should be considered. We aim to devise a new scoring
system, which can quantify the severity of DD to predict post-operative outcome.
Caucasian patients diagnosed with DD (n=92) from Northwest England were assessed for DD. Criteria for evaluating severity incorporated quantified variables
including; age at onset, bilateral and ectopic disease, family history, frequency of and recurrence following surgery, number of digits affected and combined
total flexion deformity (TFD) of all digits. Severity scores were correlated to a known staging system of DD TFD for a single affected digit.
Total severity score ranged between 3 and 37 (mean=14.1, SD=7.9) and revealed significant positive correlation to a known staging system (r=0.8, p