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Comparative Study
. 2017 Jan;12(1):78-84.
doi: 10.1177/1558944716646758. Epub 2016 Apr 29.

Biomechanical and Dimensional Measurements of the Pulvertaft Weave Versus the Cow-Hitch Technique

Nanette L A Vincken  1 , Thomas M A S Lauwers  1 , Rene R W J van der Hulst  1
Affiliations
Comparative Study

Biomechanical and Dimensional Measurements of the Pulvertaft Weave Versus the Cow-Hitch Technique

Nanette L A Vincken et al. Hand (N Y). 2017 Jan.

Abstract

Background: In this study, biomechanical strength and bulkiness of the cow-hitch technique and Pulvertaft weave were compared. Our goal was to investigate whether the cow hitch can withstand equal strength in comparison with the Pulvertaft and to see if there is a difference in bulk, which could enhance gliding function and reduce friction and adhesion formation. Methods: Sheep tendons were used to perform 10 cow-hitch and 10 Pulvertaft repairs. Tensile strength was obtained with a cyclic loading tensile testing machine and tendon width and height measurements were obtained through digital analysis by photographs of the repairs. Results: The cow hitch showed significantly better ultimate strength and had less bulk. There was no statistical difference in displacement, defined as gain in total length of the tendon. Conclusions: The results in this study show that the cow hitch outperforms the Pulvertaft weave in both ultimate strength and bulk.

Keywords: Pulvertaft; cow hitch; flexor tendon reconstruction; mechanical testing; tendon grafts; tendon transfer; tenorrhaphy.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Line drawing of a Pulvertaft repair with 3 weaves.
Figure 2.
Figure 2.
Step-by-step line drawing explaining how to perform a cow-hitch repair.
Figure 3.
Figure 3.
Graph explaining the definition of initial and ultimate failure. Note. “Initial failure” shows the first negative infliction on the repair, and “ultimate failure” is the moment in which the tendon is unable to build up ultimate strength.
Figure 4.
Figure 4.
Box plot of ultimate failure (N) comparing the Pulvertaft repair (technique 1) with the cow-hitch repair (technique 2).
Figure 5.
Figure 5.
Mechanism of failure of the Pulvertaft. Note. The extensor tendon pulls through the most distal suture, which then leads to longitudinal translation of the extensor through the incisions.
Figure 6.
Figure 6.
Mechanism of failure of the cow hitch. Note. Suture breakage occurs distal of the junction, which then leads to fiber shearing of the flexor tendon.
See this image and copyright information in PMC

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