PURPOSE: Numerous flexor tendon repairs have been previously described. The ideal core flexor tendon repair optimizes strength characteristics while minimizing factors felt to contribute to adhesion formation. The present study compares ultimate tensile strength, gap strength, and operative time in the Lahey repair, a new four-strand flexor tendon repair, to three previously described techniques.

METHOD: The flexor digitorum profundus tendons of forty porcine forelimbs were repaired in-situ using one of four flexor tendon repairs. The techniques compared included the two-strand modified Kessler repair, the four-strand Kessler repair, the cruciate repair, and the experimental Lahey repair (four-strand Kessler with cruciate modification). The operative times were recorded for all repairs. Biomechanical testing was conducted in order to obtain initial gap strength and ultimate tensile strength.

RESULTS: The 2-strand Kessler repair took significantly less time than any of the 4-strand repairs (p<0.05). The Lahey and cruciate repair took significantly less time than the 4-strand Kessler (p<0.05). All 4-strand repairs had significantly greater initial gap strength (p<0.05) and ultimate tensile strength (p<0.001) compared to the 2-strand Kessler repair. Though not significantly different from the 4-strand Kessler, the ultimate tensile strength of the Lahey repair was significantly greater than that of the cruciate repair (p<0.05).

CONCLUSION: The Lahey flexor tendon repair proved to have significantly greater ultimate tensile strength than the cruciate repair and yet took significantly less time to perform than the 4-strand Kessler repair. These findings suggest that the Lahey repair should be considered a favorable four-strand technique for the repair of flexor tendon lacerations.