Project title: Double tendon turndown repair: A biomechanical study & proposed classification

Grant Holder: Dr Manal Irshad Patel

Position: Final Year Medical Student, University of Cambridge

Summary of project/progress /findings (approx 300 words)

Since receiving the award from BSSH, we have been able to undertake the full-scale experiment, preparing and testing 48 animal-derived tendon reconstructions with an Instron tensile testing machine at the University of Cambridge Department of Engineering, measuring ultimate tensile strength and stiffness of the tendon turndown reconstruction versus more conventional tendon repair techniques. I am currently undertaking data analysis and preparing an abstract for presentation. 

What is the relevance/value of this research to hand surgery:

Upper limb trauma represents approximately 30% of A&E attendances. Flexor tendons are commonly injured resulting in loss of finger flexion. Frequently used repair techniques include tendon lengthening, grafting or tendon transfers. A less commonly described technique is tendon turndown which avoids the complications associated with other repair techniques and precludes the need for a secondary wound from graft tendon retrieval. The aim of this study is to analyse the biomechanical properties of tendon turndown repair and to evidence its utility for tendon reconstruction in the upper limb.

How has this grant awards helped your career development?

The ‘tendon turndown’ project has been in invaluable step in equipping me with skills to take a hypothesis to a proof-of-concept pilot which has led us to plan the upcoming full-scale project. I believe this is crucial in my development as I work to become a future clinician scientist.

With the support of my supervisors, I have written a basic science study protocol, coordinating between clinicians, medical suppliers and technicians at the Department of Engineering which has allowed us to run a pilot study, demonstrating feasibility and ultimately successfully running the full-scale experiment. Having analysed the pilot data, I am becoming adept in biomechanical data analysis – applying first principles in order to understand the mechanical properties of the repairs.

I am looking forward to the next steps as there is a great deal of scope to expand upon the work which could have a greater impact on patient care and outcomes.