scholarly journals BIOMECHANICS OF A NEW TECHNIQUE FOR FLEXOR TENDON TENORRAPHY OF THE HAND

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
S García Cabeza ◽  
M Lara Guerrero ◽  
F Salinas Ramila ◽  
G J Martínez Magide ◽  
S Carnero López ◽  
...  
Keyword(s):  
Tensile Strength ◽  
Ultimate Tensile Strength ◽  
Flexor Tendon ◽  
Testing Machine ◽  
Conventional Technique ◽  
Biomechanical Analysis ◽  
New Technique ◽  
Flexor Digitorum Profundus ◽  
A New Technique ◽  
Breaking Time

Abstract INTRODUCTION The present study compares ultimate tensile strength, gap strength (2, 4, 6 mm), distortion time and breaking time in a new flexor tendon suture, to a conventional technique. MATERIAL AND METHODS The flexor digitorum profundus tendons of 40 porcine forelimbs were repaired. The biomechanical analysis was carried out in a universal testing machine applying a constant speed. Tenotomy gap, the force applied and the rupture point were analysed. RESULTS The ultimate tensile strength, and 4 and 6 mm gap strength were significantly higher with the new technique compared with the conventional 4-strand cruciate technique. CONCLUSIONS The new technique is a higher provider of repair strength during early active mobilization when compared with the conventional 4-strand cruciate technique. These findings suggest that this new suture can be considered a biomechanically favourable technique for the repair of flexor tendon lacerations.

Biomechanical Analysis of a Step-Cut Technique for Flexor Tendon Repair

1992 ◽  
Vol 17 (3) ◽  
pp. 282-285 ◽  
Author(s):  
L. GORDON ◽  
J. L. GARRISON ◽  
J. C. CHENG ◽  
Y. K. LIU ◽  
R. P. NATHAN ◽  
...  
Keyword(s):  
Tensile Strength ◽  
Ultimate Tensile Strength ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Biomechanical Analysis ◽  
Flexor Digitorum Profundus ◽  
Gap Formation ◽  
Flexor Tendon Repair ◽  
The Core ◽  
Human Cadavers

We compared the strength of a new step-cut technique for flexor tendon repair with that of the widely used Kessler-Tajima technique, giving special attention to the relative contributions of the core and epitendinous sutures. 36 flexor digitorum profundus tendons from human cadavers were used. Corresponding digits from the same donor were paired, and the two tendons of each pair were placed in the Kessler-Tajima and step-cut groups, respectively. Each group had three subcategories of repair: (1) core repair alone; (2) epitendinous repair alone; and (3) full repair. In the Kessler-Tajima repair, the core stitch contributed more to ultimate tensile strength, while the epitendinous stitch contributed more to gap formation resistance. In the step-cut repair, however, the epitendinous stitch contributed more to both measures of strength. The full step-cut repair was 65% stronger in resisting gap formation and had 84% more ultimate tensile strength than the full Kessler-Tajima repair. We attribute the greater strength of the step-cut repair to the additional number of epitendinous loops, which lie perpendicular to the long axis of the tendon.

A New Core Suture Technique for Flexor Tendon Repair: Biomechanical Analysis of Tensile Strength and Gap Formation

2000 ◽  
Vol 25 (4) ◽  
pp. 390-392 ◽  
Author(s):  
A. ASLAM ◽  
A. AFOKE
Keyword(s):  
Tensile Strength ◽  
Flexor Tendon ◽  
Testing Machine ◽  
Suture Technique ◽  
Biomechanical Analysis ◽  
New Technique ◽  
Gap Formation ◽  
Tensile Testing Machine

The purpose of this study was to test in vitro a new flexor tendon suture technique that has been developed to withstand the in vivo forces of active tendon motion. This new core suture technique involves locking loops in the form of a cross stitch. The new technique was tested for ultimate tensile strength and gap formation in cadaver human flexor tendons on a tensile testing machine. The new technique proved significantly stronger than the modified Kessler core suture.

A New Technique of Attachment of Flexor Tendons to The Distal Phalanx without A Button Tie-Over

1996 ◽  
Vol 21 (5) ◽  
pp. 629-632 ◽  
Author(s):  
M. K. SOOD ◽  
D. ELLIOT
Keyword(s):  
Flexor Tendon ◽  
Distal Phalanx ◽  
New Technique ◽  
Flexor Digitorum Profundus ◽  
Flexor Tendons ◽  
Tendon Grafts ◽  
A New Technique ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

A new technique of attachment of the flexor digitorum profundus tendon and flexor tendon grafts to the distal phalanx, without using a button on the nail, is described and its use reported in 14 cases.

Asymmetric 6-Strand Flexor Tendon Repair – Biomechanical Analysis Using Barbed Suture

2019 ◽  
Vol 24 (03) ◽  
pp. 297-302
Author(s):  
Jasmin Shimin Lee ◽  
Yoke-Rung Wong ◽  
Shian-Chao Tay
Keyword(s):  
Tensile Strength ◽  
Ultimate Tensile Strength ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Biomechanical Analysis ◽  
Barbed Suture ◽  
Flexor Tendon Repair ◽  
Barbed Sutures ◽  
Repair Technique ◽  
Nylon Suture

Background: This study investigates the biomechanical performance of the Asymmetric flexor tendon repair technique using barbed suture. The Asymmetric repair technique using monofilament nylon suture was previously reported to have a higher tensile strength than the modified Lim-Tsai repair technique, but its repair stiffness and load to gap force were significantly lower. There is hence an unmet need to improve this technique and the substitution of nylon suture with barbed sutures may be the solution. Methods: Two groups consisting of 10 porcine tendons each were repaired with the six-strand Asymmetric repair technique using V-Loc® 3-0 and Supramid® 4-0 respectively. The repairs were subjected to a mechanical tester for static testing. The ultimate tensile strength, load to 2 mm gap force, repair stiffness, time taken to complete a repair and failure mechanism of the repairs were recorded and analyzed. Results: All the repairs using V-Loc® 3-0 sutures had significantly higher median values of ultimate tensile strength (64.1 N; 56.9 N), load to 2 mm gap force (39.2 N; 19.7 N), repair stiffness (6.4 N/mm; 4.7 N/mm) and time taken to complete a repair (9.4 mins; 7.7 mins). All the repairs using V-Loc® sutures failed by suture breakage while 80% of repairs using Supramid® sutures failed by suture pullout. Conclusions: The use of the barbed sutures in the Asymmetric repair technique, whilst more time consuming, has shown promising improvement to its biomechanical performance (i.e. better ultimate tensile strength, stiffness and resistance to gap formation).

An Exploratory Study Using Semi-Tabular Plate in Zone II Flexor Tendon Repair

2018 ◽  
Vol 23 (04) ◽  
pp. 547-553 ◽  
Author(s):  
Yoke-Rung Wong ◽  
Ita Suzana Mat Jais ◽  
Min-Kai Chang ◽  
Beng-Hai Lim ◽  
Shian-Chao Tay
Keyword(s):  
Tensile Strength ◽  
Ultimate Tensile Strength ◽  
Coefficient Of Friction ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Flexor Tendon Repair ◽  
Flexor Tendons ◽  
Custom Made ◽  
Zone Ii

Background: This study evaluated the feasibility of using a low-profile titanium (Ti) plate implant, also known as the Ti-button, for Zone II flexor tendon repair. We hypothesize that the use of the Ti-button can distribute the tensile force on the digital flexor tendons to achieve better biomechanical performance. Methods: Twenty lacerated porcine flexor tendons were randomly divided into two groups and repaired using Ti-button or 6-strand modified Lim-Tsai technique. Ultimate tensile strength, load to 2 mm gap force, and mode of failure were recorded during a single cycle loading test. We also harvested twelve fingers with lacerated flexor digitorum profundus tendons from six fresh-frozen cadaver hands and repaired the tendons using either Ti-button method or modified Lim-Tsai technique. A custom-made bio-friction measurement jig was used to measure the gliding resistance and coefficient of friction of the tendon sheath interface at the A2 pulley. Results: The ultimate tensile strength, load to 2 mm gap force, stiffness, and gliding resistance of the Ti-button repairs were 101.5 N, 25.7 N, 7.8 N/mm, and 2.2 N respectively. Ti-button repairs had significantly higher ultimate tensile strength and stiffness than the modified Lim-Tsai repair. However, Ti-button also increased the gliding resistance and coefficient of friction but there was no significant difference between the two repair techniques. Conclusions: Ti-button repair displayed comparable mechanical properties to the traditional repair in terms of 2-mm gap formation and gliding resistance, but with a stronger repair construct. Thus, this deepened our interest to further investigate the potential of using Ti-button implant in Zone II flexor tendon repair by studying both the mechanical and biochemical (tendon healing) properties in more in-depth.

Biomechanical comparison of the Lim/Tsai tendon repair with a modified method using a single looped suture

2017 ◽  
Vol 42 (9) ◽  
pp. 915-919 ◽  
Author(s):  
Min Kai Chang ◽  
Yoke Rung Wong ◽  
Shian Chao Tay
Keyword(s):  
Tensile Strength ◽  
Ultimate Tensile Strength ◽  
Mechanical Performance ◽  
Tendon Repair ◽  
Original Method ◽  
Flexor Digitorum Profundus ◽  
Loading Test ◽  
Modified Method ◽  
Cycle Loading ◽  
The Difference

The Lim/Tsai tendon repair technique has been modified clinically to achieve a 6-strand repair using a single looped suture with one extratendinous knot. We compared biomechanical performance of the original and modified methods using 20 porcine flexor digitorum profundus tendons. The ultimate tensile strength, load to 2 mm gap force, mode of failure, and time taken to repair each tendon were recorded during a single cycle loading test in 10 tendons with each repair method. We found that despite having the same number of core strands, the single looped suture modified Lim/Tsai technique possessed significantly greater ultimate tensile strength and load to 2 mm gap force. Also, less repair time was required. We conclude that the modified 6-strand repair using a single looped suture has better mechanical performance than the original method. The difference likely was due to the changes in locations of the knots and subsequent load distribution during tendon loading.

The Effect of Suture Materials on the Biomechanical Performance of Different Flexor Tendon Repairs and the Concept of Construct Efficiency

2018 ◽  
Vol 23 (02) ◽  
pp. 243-247
Author(s):  
Yoke Rung Wong ◽  
Austin Mun Kitt Loke ◽  
Shian Chao Tay
Keyword(s):  
Tensile Strength ◽  
Ultimate Tensile Strength ◽  
Tensile Testing ◽  
Flexor Tendon ◽  
Experimental Results ◽  
Suture Materials ◽  
Nylon Suture ◽  
Biomechanical Strength ◽  
Repair Techniques

Background: To propose a new term (‘construct efficiency’) for the evaluation of multi strands flexor tendon repairs using different suture materials. Methods: A total of twenty specimens from 4-0 braided polyblend sutures (FiberLoop/FiberWire; Arthrex, Naples, FL) and 4-0 nylon sutures (Supramid Extra II; S. Jackson, Inc., Alexandria, VA) were subjected to tensile testing using Pneumatic Cord-and-Yarn Grips (Instron Corp., Canton MA, USA). The ultimate tensile strengths of the suture materials were measured. The expected repair strengths and construct efficiencies were computed based on the experimental results and from available literature on actual repair strengths of the 4-strand Becker, Cruciate repairs and 6-strand Tang, modified Lim-Tsai repairs. Results: The ultimate tensile strength of nylon suture was 15.4 ± 0.6N, lower than that of braided polyblend suture (45.3 ± 2.3N) with a difference of 194%. The construct efficiency of multi strand repairs varied with respect to different repair techniques and suture materials. It was found that the Becker repairs using FiberWire had the highest construct efficiency (55.7%) followed by the modified Lim-Tsai using Supramid (50.9%), Tang repair using Supramid (49.8%), Cruciate repair using Fiberwire (49.1%), and modified Lim-Tsai repair using FiberLoop (33.5%). Conclusions: The construct efficiency is more accurate in showing that, in terms of biomechanical strength, the use of FiberWire for the 4-strand Becker and Cruciate repair is more efficient than that of using FiberLoop for 6-strand modified Lim-Tsai repair.

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.

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.

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.

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