A New Method in Tendon Repair - Angular Technique of Interlocking (Atik)

Abstract

Background: The risk of adhesion following flexor tendon repair, despite provision of rehabilitation by mobilization of the tendon with passive exercises without the risk of rupture, is not negligible. Active mobilization of tendons has recently been more frequently recommended to prevent adhesions of tendons. The tendon repair zone, which should withstand active traction forces, should maintain its strength until complete recovery of the tendon. For this purpose, a new treatment method named angular technique of interlocking (ATIK) has been developed. This method was compared with the Modified Kessler method, in vivo and in vitro. Materials and Methods: In four groups, each consisting of 10 chickens, severed flexor tendons repaired with the Modified Kessler and ATIK techniques were compared for biomechanical properties. Results: Although there were no differences between these techniques in vitro, this new technique's superiority was statistically significant in in vivo studies. Conclusions: The second and third postoperative weeks are periods during which the number of fibroblasts and the amount of collagen, are the highest. In these periods, edema resolves and sutures begin to loosen. In this situation, the force withstanding the active movements is the support of the suture materials and the degree of recovery of the tendon. Following this recommended suture technique and active movements, the healing potential of the tendon increases and the risk of tendon rupture owing to decrease in the force exerted per unit area decreases.