Risk of tendon failure with repeated passage of Kirschner wires or hypodermic needles: an experimental study

Abstract

During hand surgery, tendons may be at risk of damage. This biomechanical study aims to assess the risk of tendon rupture due to passage of Kirschner wires or hypodermic needles. Porcine extensor tendons were divided into four groups. Group 1: a control group was tested to ensure that repeated stress alone did not cause failure. Group 2a: 1.1-mm Kirschner wires were hand pushed through tendons 50 times and then stressed to 40 N, repeated until tendon failure. In Group 2b, K-wires were passed while rotating using a drill. Group 3: the experiment was repeated using a 20 G hypodermic needle. Group 2a tendons required a median of 2450 passes (1150–3500) to propagate failure, Group 2b a median of 2250 (1200–3850) and Group 3a median of 200 passes (150–450). The risk of tendon rupture from wires or hypodermic needles in procedures appears very low.

Keywords

Tendon Instron machine Kirschner wire hypodermic needle

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References

Domnick

Wieskötter

Raschke

, et al.

Evaluation of biomechanical properties: are porcine flexor tendons and bovine extensor tendons eligible surrogates for human tendons in in vitro studies?

Arch Orthop Trauma Surg. 2016, 136: 1465–71.

Foucher

Medina

Navarro

. Percutaneous needle aponeurotomy: complications and results. J Hand Surg Br. 2003, 28: 427–31.

Jenkins

Smith

Giddins

. Percutaneous corrective osteotomy for rotational malunion of metacarpal and phalangeal fractures. J Hand Surg Eur. 2021, 46: 420–2.

Matter-Parrat

Prunieres

Collon

Facca

Liverneaux

Hidalgo Diaz

. Active extensor indicis proprius extension strength after its use as a tendon transfer: 19 cases. Hand Surg Rehabil. 2017, 36: 36–40.

Meng

Chou

Yang

. Thickening of finger extensor tendons in affected hands among patients with stroke: prevalence and sonographic features. J Rehabil Med. 2010, 42: 853–7.

Palatty

Raveendranath

Manjunath

. Anatomical study of extensor tendons of medial four fingers in adults and fetuses-a cadaveric study. PJSR. 2015, 8: 1–13.

Peltz

Hoffman

Scougall

, et al. Animal models for tendon repair experiments: a comparison of pig, sheep and human deep flexor tendons in Zone II. J Hand Surg Asian Pac. 2017, 22: 329–36.

Rahr

Sondergaard

Bisgaard

Baad-Hansen

. Percutaneous needle fasciotomy for primary dupuytren's contracture. J Hand Surg Eur. 2011, 36: 548–52.

Synek

Pahr

. The effect of the extensor mechanism on maximum isometric fingertip forces: a numerical study on the index finger. J Biomech. 2016, 49: 3423–9.

10.

Toppi

Trompf

Smoll

, et al. Dupuytren's contracture: an analysis of outcomes of percutaneous needle fasciotomy versus open fasciectomy. ANZ J Surg. 2015, 85: 639–43.

11.

Viinikainen

Göransson

Huovinen

Kellomäki

Törmälä

Rokkanen

. The strength of the 6-strand modified kessler repair performed with triple-stranded or triple-stranded bound suture in a porcine extensor tendon model: an ex vivo study. J Hand Surg Am. 2007, 32: 510–7.

12.

Werker PM, Dias J, Eaton C, Reichert B, Wach W. Dupuytren disease and related diseases – the cutting edge. Switzerland, Springer, 2017.