The Mechanical Properties of Human Flexor Tendons in Relation to Artificial Tendons

The continuation of an unacceptable failure rate with tendon repair or grafting procedures, largely due to adhesions, suggested that an artificial flexor tendon could be an attractive alternative. A literature search found no published data of the mechanical properties of fresh human finger flexor tendons, so a study of the strength and extensibility of 153 tendons was carried out. The bone insertion strength of twenty middle finger tendons was also examined. The results showed that an artificial tendon should have a strength of approximately 1500N, and that it should extend 13% at that load, an elongation of 26mm for a tendon 200mm long. The insertion strength was less than a half of the tendon strength. This data will allow an artificial flexor tendon to be designed with sufficient strength and the correct elastic properties to allow its function to integrate reliably with natural tendons in adjacent fingers.

[1]  N L Biggs,et al.  Ultimate tensile strength of fetal and adult human tendons. , 1970, Journal of biomechanics.

[2]  N. Martin,et al.  EXPERIMENTAL EVALUATION OF FACTORS AFFECTING THE STRENGTH OF TENDON REPAIRS , 1977, Plastic and reconstructive surgery.

[3]  E. H. Harris,et al.  Stress-strain characteristics and tensile strength of unembalmed human tendon. , 1968, Journal of biomechanics.

[4]  W H Akeson,et al.  Flexor tendon healing and restoration of the gliding surface. An ultrastructural study in dogs. , 1983, The Journal of bone and joint surgery. American volume.

[5]  R. Gelberman,et al.  Intrinsic flexor-tendon repair. A morphological study in vitro. , 1984, The Journal of bone and joint surgery. American volume.

[6]  H E Kleinert,et al.  Primary flexor tendon repair followed by immediate controlled mobilization. , 1978, The Journal of hand surgery.

[7]  Design and fabrication of two types of artificial tendons for evaluation of surgical techniques. , 1975, Journal of biomedical materials research.

[8]  I. Spar Flexor tendon ruptures in the rheumatoid hand: bilateral flexor pollicis longus rupture. , 1977, Clinical orthopaedics and related research.

[9]  J. Harmon,et al.  Repair of tendon injuries of the hand. , 1960, Annals of surgery.

[10]  J. W. Strickland,et al.  Digital function following flexor tendon repair in Zone II: A comparison of immobilization and controlled passive motion techniques. , 1980, The Journal of hand surgery.

[11]  T. Hovig,et al.  The ultrastructure of normal digital flexor tendon sheath and of the tissue formed around silicone and polyethylene implants in man. , 1978, Journal of Bone and Joint Surgery-british Volume.

[12]  G. R. Motta,et al.  Tendon Ruptures in the Hand with Particular Reference to Attrition Ruptures in the Carpal Tunnel , 1982, The Hand.

[13]  Angie Legaspi,et al.  AMERICAN SOCIETY FOR SURGERY OF THE HAND , 1978, The Journal of bone and joint surgery. American volume.

[14]  Austin D. Potenza,et al.  Tendon healing within the flexor digital sheath in the dog. , 1962, The Journal of bone and joint surgery. American volume.

[15]  H C Schamhardt,et al.  The cryo-jaw, a clamp designed for in vitro rheology studies of horse digital flexor tendons. , 1982, Journal of biomechanics.

[16]  P. Lunn,et al.  “Rugby Finger”—Avulsion of Profundus of Ring Finger , 1984, Journal of hand surgery.

[17]  M. D. Northmore-ball,et al.  The strength of the profundus tendon insertion. , 1975, The Hand.

[18]  R. M. B. MacKenna,et al.  Extensor Pollicis Longus Tendon Rupture with Concomitant Rupture of the Extensor Digitorum Communis II Tendon and Extensor Indicis Proprius after Volar Plating for Distal Radius Fracture , 2017 .

[19]  D. Lou,et al.  A study of the normal range of strain, strain rate, and stiffness of tendon. , 1978, Journal of biomedical materials research.

[20]  G. Lundborg Experimental Flexor Tendon Healing without Adhesion Formation — A New Concept of Tendon Nutrition and Intrinsic Healing Mechanisms , 1976 .

[21]  I. Kessler,et al.  Primary repair without immobilization of flexor tendon division within the digital sheath. An experimental and clinical study. , 1969, Acta orthopaedica Scandinavica.

[22]  M Abrahams,et al.  Mechanical behaviour of tendon in vitro. A preliminary report. , 1967, Medical & biological engineering.

[23]  G. S. Phalen,et al.  Ruptures of the flexor tendons in hands of non-rheumatoid patients. , 1972, The Journal of bone and joint surgery. American volume.

[24]  J C Barbenel,et al.  Structural and mechanical properties of tendon related to function. , 1975, Equine veterinary journal.

[25]  B. F. Martin,et al.  The tendons of flexor digitorum profundus. , 1958, Journal of anatomy.

[26]  J. Boyes,et al.  Flexor-tendon ruptures in the forearm and hand. , 1960, The Journal of bone and joint surgery. American volume.

[27]  G A Murray,et al.  A review of work on artificial tendons. , 1979, Journal of biomedical engineering.

[28]  P. Stern Multiple flexor tendon ruptures following an old anterior dislocation of the lunate. A case report. , 1981, The Journal of bone and joint surgery. American volume.

[29]  D. S. Bright,et al.  Vascularization and the gliding mechanism of free flexor-tendon grafts inserted by the silicone-rod method. , 1974, The Journal of bone and joint surgery. American volume.

[30]  Alfred Eugene Cronkite,et al.  The tensile strength of human tendons , 1935 .