Flexor Tendon Repair Using a Stainless Steel External Splint

1999 ◽  
Vol 24 (6) ◽  
pp. 654-657 ◽  
Author(s):  
L. GORDON ◽  
F. A. DYSARZ ◽  
K. T. VENKATESWARA ◽  
A. P. MOK ◽  
R. O. RITCHIE ◽  
...  
Keyword(s):  
Tensile Strength ◽  
Stainless Steel ◽  
Testing Machine ◽  
Biomechanical Testing ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Tensile Testing Machine ◽  
In Vivo Testing ◽  
Flexor Digitorum

A stainless steel external tendon splint was used in repair of cadaver tendons and compared with standard tendon repairs with suture. The splint was combined with a Kessler repair and tested against the Kessler, Becker, and Savage repairs in fresh human cadaver flexor digitorum profundus tendons. Biomechanical testing was done on a tensile testing machine, and load-displacement curves were generated. The repairs using the external tendon splint demonstrated a range of improvement of 32 to 146% in mean maximal tensile strength and a 20 to 185% improvement of mean ultimate tensile strength compared with all other repairs. The external tendon splint is relatively easy to apply to a tendon. The repair is strengthened and becomes capable of withstanding early active range of motion excercises. In vivo testing will be needed to assess the potential clinical usefulness of such a device.

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.

Comparison of Postoperative Early Active Mobilization and Immobilization in Vivo Utilising a Four-Strand Flexor Tendon Repair

2001 ◽  
Vol 26 (4) ◽  
pp. 301-306 ◽  
Author(s):  
A. WADA ◽  
H. KUBOTA ◽  
K. MIYANISHI ◽  
H. HATANAKA ◽  
H. MIURA ◽  
...  
Keyword(s):  
Ultimate Strength ◽  
Flexor Tendon ◽  
Testing Machine ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Gap Formation ◽  
Flexor Tendon Repair ◽  
Tensile Testing Machine ◽  
Active Mobilization

We evaluated a technique of four-strand double-modified locking Kessler flexor tendon repair in healing tendons. Seventy-two canine flexor digitorum profundus tendons in Zone 2 were repaired and evaluated following either active mobilization or immobilization at 0, 7, 14, 28 and 42 days after surgery. Fifty-six tendons were examined for gap and ultimate strength using a tensile testing machine and 16 were evaluated with standard hematoxylin and eosin, and Masson’s trichrome staining. All tendons healed without rupture or gap formation of more than 1 mm, thus demonstrating that this repair technique has enough tensile strength to withstand early active mobilization. The gap and ultimate strength of actively mobilized tendons did not decrease significantly during the first 7 days, and were significantly greater than those of immobilized tendons throughout the 42-day study period. Actively mobilized tendons healed without the extrinsic adhesions and large tendon calluses that were found in immobilized tendons.

The Mechanical Properties of Locking and Grasping Suture Loop Configurations in Four-Strand Core Suture Techniques

2000 ◽  
Vol 25 (6) ◽  
pp. 548-551 ◽  
Author(s):  
A. WADA ◽  
H. KUBOTA ◽  
H. HATANAKA ◽  
S. HOTOKEZAKA ◽  
H. MIURA ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Tensile Testing ◽  
Testing Machine ◽  
Tendon Repair ◽  
Suture Techniques ◽  
Flexor Digitorum Profundus ◽  
Tensile Testing Machine ◽  
Pull Out ◽  
Mode Of Failure ◽  
Flexor Digitorum

We have compared the effect of locking and grasping suture loop configurations in four-strand core suture techniques for tendon repair. Forty canine flexor digitorum profundus tendons were repaired with one of four suture techniques (the grasping cruciate, the double-modified grasping Kessler, the locking cruciate and the double-modified locking Kessler) and tested to failure in a tensile testing machine. The mode of failure in all the locking suture specimens was breakage of the sutures in the locking loops or at suture knots. The sutures did not pull out of the tendon, as was seen in the grasping suture specimens. The greatest tensile strength was found with the double-modified locking Kessler technique which incorporated eight rectangular locking loop configurations.

Optimization of ultimate tensile strength of welded Inconel 625 and duplex 2205

2021 ◽  
Vol 15 (1) ◽  
pp. 7715-7728
Author(s):  
S. Madhankumar ◽  
K. Manonmani ◽  
V. Karthickeyan ◽  
N. Balaji
Keyword(s):  
Tensile Strength ◽  
Stainless Steel ◽  
Ultimate Tensile Strength ◽  
Research Work ◽  
Testing Machine ◽  
Laser Beam Welding ◽  
Inconel 625 ◽  
Bead Geometry ◽  
Tensile Testing Machine ◽  
Inconel 625 Alloy

The ultimate strength is an important property of any material for the manufacturing of components. This paper utilized the laser beam welding (LBW), due to its smaller dimension, which produces lesser distortion and process velocity is higher. Inconel 625 alloy and duplex 2205 stainless steel is having higher strength and corrosive resistance properties. Due to the above-mentioned properties, it could be used in oil and gas storage containers, marine and geothermal applications. This research work presents an investigation of various input variable effects on the output variable (ultimate tensile strength) in LBW for dissimilar materials namely, Inconel 625 alloy and duplex 2205 stainless steel. The input variables for this research are the power of a laser, welding speed, and focal position. The experimental runs are developed with the help of design of experiment (DOE) and utilized statistical design expert software. The ultimate tensile strength on different runs is measured using a universal tensile testing machine. Then from a response surface methodology and ANOVA, the optimum value of ultimate tensile strength was determined to maximize the weld joint and bead geometry. Finally, the confirmation test was carried out, it reveals the maximum error of 0.912% with the predicted value. In addition, the microstructure of the weld beads was examined using optical microscopy.

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.

Comparison of the Mechanical Properties of Polyglycolide-Trimethylene Carbonate (Maxon) and Polydioxanone Sutures (PDS2) used for Flexor Tendon Repair and Active Mobilization

2002 ◽  
Vol 27 (4) ◽  
pp. 329-332 ◽  
Author(s):  
A. WADA ◽  
H. KUBOTA ◽  
M. TAKETA ◽  
H. MIURA ◽  
Y. IWAMOTO
Keyword(s):  
Mechanical Properties ◽  
Tensile Strength ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Trimethylene Carbonate ◽  
Flexor Tendon Repair ◽  
Active Mobilization ◽  
Flexor Digitorum ◽  
Observation Period

Thirty-six canine flexor digitorum profundus tendons were repaired using 5-0 polyglycolide-trimethylene carbonate monofilament (Maxon) or polydioxanone monofilament (PDS2). All the tendons healed without rupture or formation of gaps of more than 2 mm. Mechanically, all tendon repairs had sufficient tensile strength to enable active mobilization. Polyglycolide-trimethylene carbonate (Maxon) repairs were initially superior in gap and ultimate strength to polydioxanone (PDS2) repairs. However, the gap and ultimate tensile strength of polyglycolide-trimethylene carbonate (Maxon) repairs had decreased significantly at day 14, whereas polydioxanone (PDS2) repairs maintained their strength throughout the 28-day observation period.

Absorbable Sutures in Tendon Repair

1995 ◽  
Vol 20 (4) ◽  
pp. 505-508 ◽  
Author(s):  
E. S. O’BROIN ◽  
M. J. EARLEY ◽  
H. SMYTH ◽  
A. C. B. HOOPER
Keyword(s):  
Tensile Strength ◽  
Rabbit Model ◽  
Tendon Repair ◽  
Tendon Healing ◽  
Flexor Digitorum Longus ◽  
Absorbable Sutures ◽  
Significant Difference ◽  
Intact Rabbit ◽  
Flexor Digitorum

The risks of foreign implantation may be avoided in tendon repair by the use of absorbable sutures, for example polydioxanone. In this study, the in vivo tensile strength half-life of 4/0 polydioxanone was found to be approximately 4 weeks. Using a rabbit model, we compared polydioxanone tendon repairs with polypropylene tendon repairs. Unilateral flexor digitorum longus repairs were performed on 46 rabbits using either polydioxanone or polypropylene. Tendons were harvested at 3 days, 2 weeks and 4 weeks and the tensile breaking strengths were obtained. 30 intact rabbit flexor digitorum longus tendons and 20 freshly repaired tendons were also tested. By 4 weeks, the repair strength had increased eight-fold from approximately 20 N to 166 N. The sutures made little contribution to the overall strength of a 4-week-old repair. There was no significant difference between polydioxanone and polypropylene repairs at any stage. These results show that polydioxanone repairs were as strong as polypropylene during the first critical weeks of tendon healing.

In vivo flexor tendon forces generated during different rehabilitation exercises

2015 ◽  
Vol 40 (7) ◽  
pp. 705-710 ◽  
Author(s):  
S. Edsfeldt ◽  
D. Rempel ◽  
K. Kursa ◽  
E. Diao ◽  
L. Lattanza
Keyword(s):  
Flexor Tendon ◽  
Controlled Trial ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Neutral Position ◽  
Flexor Digitorum Superficialis ◽  
Flexor Tendon Repair ◽  
Finger Flexion ◽  
Flexor Digitorum

We measured in vivo forces in the flexor digitorum profundus and the flexor digitorum superficialis tendons during commonly used rehabilitation manoeuvres after flexor tendon repair by placing a buckle force transducer on the tendons of the index finger in the carpal canal during open carpal tunnel release of 12 patients. We compared peak forces for each manoeuvre with the reported strength of a flexor tendon repair. Median flexor digitorum profundus force (24 N) during isolated flexor digitorum profundus flexion and median flexor digitorum superficialis force (13 N) during isolated flexor digitorum superficialis flexion were significantly higher than during the other manoeuvres. Significantly higher median forces were observed in the flexor digitorum superficialis with the wrist at 30° flexion (6 N) compared with the neutral wrist position (5 N). Median flexor digitorum profundus forces were significantly higher during active finger flexion (6 N) compared with place and hold (3 N). Place and hold and active finger flexion with the wrist in the neutral position or tenodesis generated the lowest forces; isolated flexion of these tendons generated higher forces along the flexor tendons. Level of evidence: III (controlled trial without randomization)

Effect of Suture Knots on Tensile Strength of Repaired Canine Flexor Tendons

1995 ◽  
Vol 20 (1) ◽  
pp. 72-75 ◽  
Author(s):  
M. AOKI ◽  
D. L. PRUITT ◽  
H. KUBOTA ◽  
P. R. MANSKE
Keyword(s):  
Tensile Strength ◽  
Ultimate Tensile Strength ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Repair Site ◽  
Flexor Tendons ◽  
The One ◽  
Flexor Digitorum

59 dog cadaver flexor digitorum profundus tendons were repaired with one or two knots inside or outside the tendon, using two, four and six suture strands. The ultimate tensile strength and gap strengths were compared. Locating the knots outside rather than within the tendon repair site showed significantly higher ultimate tensile strength for two, four, and six strand sutures. The strength was greater in one knot than in two knot sutures; the value of the six-strand suture using the one knot outside technique was the greatest. Similarly, increased gap strength was also obtained from the one-knot-outside technique. We concluded that the knots should be located away from the tendon repair site and there should be as few as possible.

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