Changes in Tendon Strength After Partial Cut and Effects of Running Peripheral Sutures

2003 ◽  
Vol 28 (5) ◽  
pp. 478-482 ◽  
Author(s):  
J. TAN ◽  
B. WANG ◽  
B. TAN ◽  
Y. XU ◽  
J. B. TANG
Keyword(s):  
Tensile Strength ◽  
Tensile Properties ◽  
Ultimate Strength ◽  
The Other ◽  
Flexor Digitorum Profundus ◽  
Gap Formation ◽  
Load To Failure ◽  
Flexor Digitorum ◽  
Lower Tensile Strength

We performed a study to evaluate the tensile properties of partial tendon lacerations and the effects of peripheral sutures on the tendon strength. Seventy-two fresh pig flexor digitorum profundus tendons were divided equally into eight groups. Tendons in four of the groups were subjected to partial lacerations (60%, 70%, 80%, and 90%) and were not repaired. In the other four similar groups partial lacerations were repaired with running peripheral sutures. The tendons were subjected to load-to-failure tests in an Instron tensile machine to determine the initial, 1 mm, 2 mm gap formation forces and the ultimate strength. The tendons with lacerations of 80% and 90% had a remarkably lower tensile strength than those 60% and 70% lacerations. Running peripheral sutures increased the gap formation forces and the ultimate strength of all the tendons, though particularly those with 80% and 90% lacerations.

Repairs of Partial Oblique Tendon Injuries: A Biomechanical Evaluation

2004 ◽  
Vol 29 (4) ◽  
pp. 381-385 ◽  
Author(s):  
J. TAN ◽  
L. MING ◽  
Z.J. JIA ◽  
J.B. TANG
Keyword(s):  
Ultimate Strength ◽  
Cross Section ◽  
Testing Machine ◽  
Transverse Cross Section ◽  
Flexor Digitorum Profundus ◽  
Gap Formation ◽  
Tensile Testing Machine ◽  
Load To Failure ◽  
Biomechanical Evaluation ◽  
Flexor Digitorum

This study evaluated the tensile properties of oblique partial tendon lacerations and the effects of peripheral sutures on their strength. Seventy-four fresh pig flexor digitorum profundus tendons were divided into eight groups and were transected across 90% of their diameter. The lacerations in the tendons of five of the groups were at 0°, 15°, 30°, 45°, and 60° to their transverse cross-section, respectively. In the other three groups the lacerations were 0°, 45°, and 60° to the cross-section and were repaired with running peripheral sutures. The tendons were subjected to load-to-failure tests in a tensile testing machine to determine the initial, 1 and 2 mm gap formation forces, and the ultimate strength. Obliquity of tendon lacerations affected the strength of partially lacerated tendons. The tendons with 45° and 60° oblique lacerations had a significantly lower ultimate strengths than those with transverse (0°), or 15° or 30° oblique lacerations. Running peripheral sutures significantly increased both the gap formation forces and the ultimate strength of the tendons with oblique partial lacerations.

Simplifying four-strand flexor tendon repair using double-stranded suture: a comparative ex vivo study on tensile strength and bulking

2012 ◽  
Vol 37 (2) ◽  
pp. 101-108 ◽  
Author(s):  
T. H. Low ◽  
T. S. Ahmad ◽  
E. S. Ng
Keyword(s):  
Tensile Strength ◽  
Flexor Tendon ◽  
Ex Vivo ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Flexor Tendon Repair ◽  
Significant Difference ◽  
Load To Failure ◽  
Fresh Frozen ◽  
Flexor Digitorum

We have compared a simple four-strand flexor tendon repair, the single cross-stitch locked repair using a double-stranded suture (dsSCL) against two other four-strand repairs: the Pennington modified Kessler with double-stranded suture (dsPMK); and the cruciate cross-stitch locked repair with single-stranded suture (Modified Sandow). Thirty fresh frozen cadaveric flexor digitorum profundus tendons were transected and repaired with one of the core repair techniques using identical suture material and reinforced with identical peripheral sutures. Bulking at the repair site and tendon–suture junctions was measured. The tendons were subjected to linear load-to-failure testing. Results showed no significant difference in ultimate tensile strength between the Modified Sandow (36.8 N) and dsSCL (32.6 N) whereas the dsPMK was significantly weaker (26.8 N). There were no significant differences in 2 mm gap force, stiffness or bulk between the three repairs. We concluded that the simpler dsSCL repair is comparable to the modified Sandow repair in tensile strength, stiffness and bulking.

THE EFFECT OF FREEZE STORAGE ON THE TENSILE PROPERTIES OF TENDONS

2003 ◽  
Vol 03 (03n04) ◽  
pp. 299-308 ◽  
Author(s):  
BOON-HO NG ◽  
SIAW-MENG CHOU
Keyword(s):  
Tensile Strength ◽  
Ultimate Tensile Strength ◽  
Tensile Properties ◽  
Structural Integrity ◽  
Freeze Storage ◽  
Flexor Digitorum Profundus ◽  
Minor Effect ◽  
Fiber Density ◽  
A Minor ◽  
Flexor Digitorum

The objective of the current study is to elucidate the influence of freeze storage on the tensile properties of tendons by testing specimens at numerous adjacent durations to eliminate the influence of biological variation and experimental errors. Chicken flexor digitorum profundus tendons were stored intact in the digits at -20°C and specimens were tensile tested at 33 durations over 360 days. Scanning electron microscopy was done on fresh specimens and specimens freeze-stored for 30, 233 and 427 days to investigate microstructure change after freeze storage. The tensile properties of tendons, as represented by ultimate tensile strength, strained at ultimate tensile strength. The elastic modulus did not deviate significantly (p>0.01) after freeze storage while the collagen fiber density of specimens stored for 233 and 427 days decreased with porosity growth. In contrast, no obvious microstructure difference was observed between fresh tendons and tendons stored for 30 days. These findings suggest that the postmortem degradation incurred a minor effect on the structural integrity of the tendons and therefore did not affect the overall tensile properties. We conclude that freeze storage at -20°C does not alter the tensile properties of tendons for as many as 360 days.

The Changes in the Tensile Properties of Tendons after Freeze Storage in Saline Solution

2005 ◽  
Vol 219 (6) ◽  
pp. 387-392 ◽  
Author(s):  
Boon Ho Ng ◽  
Siaw Meng Chou ◽  
Beng Hai Lim ◽  
Alphonsus Chong
Keyword(s):  
Tensile Strength ◽  
Tensile Properties ◽  
Saline Solution ◽  
Collagen Fibre ◽  
Freeze Storage ◽  
Flexor Digitorum Profundus ◽  
Mean Values ◽  
Sem Study ◽  
The Mean ◽  
Flexor Digitorum

The objective of this study is to evaluate the influence of saline solution (0.9 per cent NaCl) on the tensile properties of freeze-stored tendons. Firstly, 170 pieces of chicken flexor digitorum profundus tendons were retrieved and wrapped in saline-soaked gauze before they were stored at -40 °. Then specimens were tensile tested at various time points over 360 days, scanning electron microscopy (SEM) was performed on fresh specimens, and specimens were freeze-stored for 233 days to investigate microstructure change after freeze storage. The mean values of strain ultimate tensile strength (UTS) did not deviate significantly (analysis of variance; p = 0.249) following freeze storage while the UTS and elastic modulus increased gradually with the duration of freeze storage and the growth became significant ( p < 0.01) for durations longer than 70 and 40 days respectively. The SEM study showed that the collagen fibre density of specimens stored for 233 days decreased because of porosity growth. These findings suggested that the saline increased the tensile strength and modulus of the collagen.

The consistency and reliability of six-strand and four-strand flexor tendon repairs: a comparative porcine cadaveric study

2022 ◽  
pp. 175319342110665
Author(s):  
Jaakko A. E. Kuronen ◽  
Benjamin Riski ◽  
Olli V. Leppänen ◽  
Teemu Karjalainen ◽  
Lasse Linnanmäki
Keyword(s):  
Flexor Tendon ◽  
Testing Machine ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Gap Formation ◽  
Load To Failure ◽  
Level Of Experience ◽  
Flexor Digitorum ◽  
Material Testing Machine ◽  
Technical Reliability

The aim of this study was to compare the consistency and reliability of the six-strand Gan modification of the Lim-Tsai flexor tendon repair with the four-strand Adelaide repair, both with 3-0 sutures and with eight to ten runs of simple 5-0 running peripheral suture as well as the influence of the surgeons’ level of experience on the strength of the repair in a cadaveric animal setup. Thirty-nine surgeons repaired 78 porcine flexor digitorum profundus tendons with either the Adelaide technique (39 tendons) or the modified Lim-Tsai technique (39 tendons). Each repaired tendon was tested in a material testing machine under a single cycle load-to-failure test. The forces were recorded when the gap between the two tendon stumps reached 1 and 2 mm and when irreversible elongation or total rupture occurred. We found no significant differences in gap formation force and yielding strength of the tendons between the two methods. The surgeon’s previous experience in tendon repairs did not improve the consistency, reliability or tensile strength of the repairs. We conclude that if a strong peripheral suture is added, the modified Lim-Tsai repair has the same technical reliability and consistency as the Adelaide repair in term of ultimate loading strength in this test setup.

Increased Suture Embedment in Tendons: An Effective Method to Improve Repair Strength

2002 ◽  
Vol 27 (4) ◽  
pp. 333-336 ◽  
Author(s):  
B. WANG ◽  
J. B. TANG
Keyword(s):  
Tensile Strength ◽  
Tensile Properties ◽  
Ultimate Strength ◽  
Tensile Testing ◽  
Testing Machine ◽  
Gap Formation ◽  
Tensile Testing Machine ◽  
Flexor Tendons ◽  
Important Contributor ◽  
Complete Failure

We evaluated the effect of length of suture embedment within tendons on the tensile strength of repaired tendons. Thirty fresh pig flexor tendons were divided into three groups and subjected to repairs with the Halsted tendon sutures in which 1/3, 1/2, and 2/3 of the length of the longitudinal sutures was embedded within the tendons. The repaired tendons were pulled to complete failure by an Instron tensile testing machine. The 2 mm gap-formation force, ultimate strength, stiffness, and energy to failure were greatest when 2/3 of the suture length was embedded within the tendon. The results indicate that suture embedment is an important contributor to the tensile properties of the repair, and that increase in length of suture embedment is an effective way to strengthen tendon repairs.

Flexor Tendon Repair Using a Stainless Steel Internal Anchor

1998 ◽  
Vol 23 (1) ◽  
pp. 37-40 ◽  
Author(s):  
L. GORDON ◽  
M. TOLAR ◽  
K. T. VENKATESWARA RAO ◽  
R. O. RITCHIE ◽  
S. RABINOWITZ ◽  
...  
Keyword(s):  
Tensile Strength ◽  
Stainless Steel ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Flexor Tendon Repair ◽  
Active Flexion ◽  
Active Range Of Motion ◽  
Flexor Digitorum

We have developed a stainless steel internal tendon anchor that is used to strengthen a tendon repair. This study tested its use in vitro to produce a repair that can withstand the tensile strength demands of early active flexion. Fresh human cadaver flexor digitorum profundus tendons were harvested, divided, and then repaired using four different techniques: Kessler, Becker or Savage stitches, or the internal tendon anchor. The internal splint repairs demonstrated a 99–270% increase in mean maximal linear tensile strength and a 49–240% increase in mean ultimate tensile strength over the other repairs. It is hoped that this newly developed internal anchor will provide a repair that will be strong enough to allow immediate active range of motion.

Biomechanical Evaluation of a Four-Strand Modification of the Tang Method of Tendon Repair

2005 ◽  
Vol 30 (4) ◽  
pp. 374-378 ◽  
Author(s):  
Y. CAO ◽  
J. B. TANG
Keyword(s):  
Ultimate Strength ◽  
Testing Machine ◽  
Tendon Repair ◽  
Gap Formation ◽  
Single Cycle ◽  
Tensile Testing Machine ◽  
Load To Failure ◽  
Biomechanical Evaluation ◽  
Finger Motion ◽  
Initial Force

We report a four-strand modification of the Tang technique of tendon repair that uses fewer sutures and fewer knots on the tendon surface. This repair consists of four longitudinal and two horizontal strands that form a “U” configuration within the tendon made with a single looped suture. Thirty-four fresh pig flexor tendons were divided into 3 groups and repaired with the four-strand modified Tang method, a double-looped four-strand method or a double Kessler repair (four-strand). The tendons were subjected to a single cycle of load-to-failure test in a tensile testing machine. The initial force, 2-mm gap formation force and ultimate strength of the four-strand modified Tang repair were statistically identical to those of the double looped suture and were superior to those of the double Kessler repair. Ultimate strength was 43.4 ± 4.3 N for the four-strand modified Tang method, 45.2 ± 4.0 N for the double-looped method and 39.1 ± 4.0 N for the double Kessler repair. The four-strand modification of the Tang method appears to have strength sufficient for protected active finger motion. Given our preliminary clinical experience with this method, we recommend this new and simplified technique for clinical flexor tendon repairs.

scholarly journals Activation of individual extrinsic thumb muscles and compartments of extrinsic finger muscles

2013 ◽  
Vol 110 (6) ◽  
pp. 1385-1392 ◽  
Author(s):  
J. Alexander Birdwell ◽  
Levi J. Hargrove ◽  
Todd A. Kuiken ◽  
Richard F. ff. Weir
Keyword(s):  
Neural Control ◽  
Muscular Activity ◽  
Middle Finger ◽  
The Other ◽  
Flexor Digitorum Profundus ◽  
Human Hand ◽  
Activity Levels ◽  
Extensor Pollicis Longus ◽  
Flexor Digitorum ◽  
Different Levels

Mechanical and neurological couplings exist between musculotendon units of the human hand and digits. Studies have begun to understand how these muscles interact when accomplishing everyday tasks, but there are still unanswered questions regarding the control limitations of individual muscles. Using intramuscular electromyographic (EMG) electrodes, this study examined subjects' ability to individually initiate and sustain three levels of normalized muscular activity in the index and middle finger muscle compartments of extensor digitorum communis (EDC), flexor digitorum profundus (FDP), and flexor digitorum superficialis (FDS), as well as the extrinsic thumb muscles abductor pollicis longus (APL), extensor pollicis brevis (EPB), extensor pollicis longus (EPL), and flexor pollicis longus (FPL). The index and middle finger compartments each sustained activations with significantly different levels of coactivity from the other finger muscle compartments. The middle finger compartment of EDC was the exception. Only two extrinsic thumb muscles, EPL and FPL, were capable of sustaining individual activations from the other thumb muscles, at all tested activity levels. Activation of APL was achieved at 20 and 30% MVC activity levels with significantly different levels of coactivity. Activation of EPB elicited coactivity levels from EPL and APL that were not significantly different. These results suggest that most finger muscle compartments receive unique motor commands, but of the four thumb muscles, only EPL and FPL were capable of individually activating. This work is encouraging for the neural control of prosthetic limbs because these muscles and compartments may potentially serve as additional user inputs to command prostheses.

scholarly journals Reinforcement of natural rubber and epoxidized natural rubbers with fillers

2019 ◽  
Vol 1 (1) ◽  
pp. 12-21 ◽  
Author(s):  
Indra Surya ◽  
Nabil Hayeemasae
Keyword(s):  
Tensile Strength ◽  
Carbon Black ◽  
Surface Chemistry ◽  
Natural Rubber ◽  
The Other ◽  
Reinforcement Effect ◽  
Cure Time ◽  
Filler Dispersion ◽  
The Difference ◽  
Lower Tensile Strength

The reinforcement of natural rubber (NR) and epoxidized natural rubbers (ENRs) with silica or carbon black (CB) by using a semi-efficient sulfur accelerated vulcanization system has been carried out. It was found that silica caused a longer in cure time compared to CB and due to the dissimilarity of their surface chemistry, it was also found that silica and CB caused the difference in reinforcement effect to those rubbers. Silica caused in filled-vulcanizates of those rubbers with a higher modulus and lower tensile strength compared to their unfilled ones. On the other hand, CB caused enhancements in both modulus and tensile to those rubbers. The investigation on reinforcing efficiencies of those fillers on the rubbers found that the higher reinforcing efficiency of CB was attributed to its better degree of filler dispersion when compared to silica.

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