• Abuzer Uludağ, Hacı Bayram Tosun, Suat Çelik, Sancar Serbest, Murat Kayalar, Güneş Aytaç, Muzaffer Sindel, Fatma Kübra Erbay Elibol, and Teyfik Demir.
• Department of Orthopaedics and Traumatology, Faculty of Medicine, Adiyaman University, 02100, Adiyaman, Turkey. uludagabuzer@gmail.com.
• Arch Orthop Trauma Surg. 2020 Apr 1; 140 (4): 583-590.

PurposeTo compare five different repair techniques for extensor tendon zone III modified Kessler (MK), double-modified Kessler (DMK), modified Kessler epitendinous (MKE), double-modified Kessler epitendinous (DMKE), and running-interlocking horizontal mattress (RIHM) in terms of shortening, stiffness, gap formation, and ultimate load to failure.MethodsA total of 35 human cadaver fingers were randomly assigned to five suture techniques with 7 fingers each and were tested under dynamic and static loading conditions.ResultsDMK was found to be superior over MK in terms of ultimate load to failure (36 N vs. 24 N, respectively), shortening (1.75 vs. 2.20 mm, respectively) and gap formation. However, these two methods had similar characteristics in terms of stiffness. The addition of epitendinous sutures to the repair methods resulted in approximately 40% increase in ultimate load to failure, whereas epitendinous sutures had no effect on shortening. DMKE was found to be superior over MKE in terms of shortening (1.77 vs. 2.22 mm, respectively). However, these two methods had similar characteristics in terms of mean ultimate load to failure and stiffness. RIHM was found to be superior over the other four methods in terms of ultimate load to failure (89 N), stiffness, and shortening (0.75 mm).ConclusionRIHM was found to be stronger and more durable for extensor tendon zone III than the other techniques in terms of ultimate load to failure and stiffness.

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