Digital pulley reconstruction with expanded polytetrafluoroethylene (PTFE) membrane at the time of tenorrhaphy in an experimental animal model

Digital pulley reconstruction with a synthetic material, PTFE membrane, was compared with suture repair of the native A3 pulley at the time of tenorrhaphy in the chicken model. The surgically treated foot was immobilized in flexion for either 28 or 35 days and then allowed full ambulation for periods of up to 42 days postoperatively. At sacrifice digits underwent range-of-motion testing, and the pulley and tenorrhaphy sites were explored. No disruptions were noted in the reconstructed PTFE pulleys. The number of tenorrhaphy disruptions was similar between the PTFE pulley group (11%) and the suture repair of the native pulley group (14%). No decrease in range of motion was demonstrated in the PTFE pulley digits, and no deleterious effect of increasing immobilization time (35 days versus 28 days) was noted. The results indicate that this synthetic pulley did not interfere with normal tendon healing processes. PTFE membrane may prove to be a promising reconstructive alternative when the native pulley is irreparably damaged.