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Der Erfolg der Beugesehnennaht hängt von vielen Faktoren ab. Ein wichtiger Faktor ist dabei die Sehnennahttechnik, die bei Beugesehnen wesentlich aufwendiger und exakter ausgeführt werden muss als an allen anderen Sehnen des Körpers. Welche bedeutenden operationstechnischen Punkte müssen bei der Beugesehnennaht beachtet werden? Die bedeutendsten technischen Details zur Beugesehnennaht aus der Literatur und der persönlichen Erfahrung werden zusammengestellt. Es werden Details zur Kernnaht, zur Ringnaht, zur Reißfestigkeit, zum Nahtmaterial, zur Lückenbildung, zur Durchblutung der Sehne bei liegender Naht, zum Gleitverhalten und zur Sehnenstumpfanfrischung diskutiert. Die Beugesehnennaht muss sehr sorgfältig und gewebeschonend ausgeführt werden. The success of the flexor tendon suture depends on many factors. An important factor is that the tendon suture technique that must be carried out for flexor tendons is considerably more complex and more precise than for all other tendons of the body. To discover important technical points that need to be considered during flexor tendon suturing. We compiled the most important technical details in flexor tendon suturing from the literature and from personal experience. Details on core suture, peripheral suture, the tensile strength, gapping, the circulation of sutured tendons, gliding resistance and excisions are discussed. Flexor tendon suturing must be performed taking great care to conserve tissue.

The augmentation of fixation with bone cement is increasingly being used in the treatment of severe osteoporotic fractures. We investigated the influence of bone quality on the mechanics of augmentation of plate fixation in a distal femoral fracture model (AO 33 A3 type). Eight osteoporotic and eight non-osteoporotic femoral models were randomly assigned to either an augmented or a non-augmented group. Fixation was performed using a locking compression plate. In the augmented group additionally 1 ml of bone cement was injected into the screw hole before insertion of the screw. Biomechanical testing was performed in axial sinusoidal loading. Augmentation significantly reduced the cut-out distance in the osteoporotic models by about 67% (non-augmented mean 0.30 mm (sd0.08) vs augmented 0.13 mm (sd0.06); p = 0.017). There was no statistical reduction in this distance following augmentation in the non-osteoporotic models (non-augmented mean 0.15 mm (sd0.02) vs augmented 0.15 mm (sd0.07); p = 0.915). In the osteoporotic models, augmentation significantly increased stability (p = 0.017).Cite this article: Bone Joint J2013;95-B:1406–9.