Fibrin glue augmentation for flexor tendon repair increases friction compared with epitendinous suture

N. Michael Xu, Philip J. Brown, Johannes F. Plate, Omar F. Nazir, George S. Gluck, Joel D. Stitzel, Zhongyu Li

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Purpose To compare the gliding resistance, repair gapping, and ultimate strength of a common suture construct with a modified construct with fibrin glue augmentation. Methods Twelve human cadaveric flexor digitorum profundus tendons were transected and repaired with a 4-strand core suture. Specimens were divided into 2 groups and augmented with epitendinous suture (n = 6) or fibrin glue (n = 6). We compared gliding resistance, 2-mm gapping, and ultimate strength of the repaired tendon between groups. Results The linear stiffness, force to produce a 2-mm gap, and ultimate failure were similar in both repair methods. However, the 4-strand suture repair with fibrin glue augmentation displayed significantly higher gliding resistance compared with the 4-strand suture with a running epitendinous suture. Conclusions The significantly increased gliding resistance associated with fibrin glue raises questions regarding the use of this material for flexor tendon repair augmentation. Clinical relevance In a human cadaveric study, fibrin glue augmentation to zone II flexor tendon repairs significantly increased friction in the tendon sheath compared with an epitendinous suture.

Original languageEnglish (US)
Pages (from-to)2329-2334
Number of pages6
JournalJournal of Hand Surgery
Issue number12
StatePublished - Dec 2013
Externally publishedYes


  • Biomechanics
  • gliding resistance
  • repair gapping
  • repair strength
  • zone II repair

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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