Symmetric Peripheral Running Sutures are Superior to Asymmetric Peripheral Running Sutures for Increasing the Tendon Strength in Flexor Tendon Repair

2017 ◽  
Vol 22 (02) ◽  
pp. 208-213 ◽  
Author(s):  
N. Takeuchi ◽  
T. Okada ◽  
N. Kozono ◽  
T. Shimoto ◽  
H. Higaki ◽  
...  
Keyword(s):  
Fatigue Strength ◽  
Cyclic Loading ◽  
Cyclic Load ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Suture Techniques ◽  
Flexor Tendon Repair ◽  
Flexor Digitorum

Background: The fatigue strength of three peripheral suture techniques for flexor tendon repair was compared by cyclic loading of the repairs in the porcine flexor digitorum tendon. Methods: Thirty-six tendons were sutured using only peripheral sutures with 6-0 Nylon. An initial cyclic load of 10 N for 500 cycles was applied and increased by 10 N for an additional 500 cycles at each new load until rupture. Results: The fatigue strength of the symmetric running peripheral suture was 85.0% and 144.8% greater than that of the two kinds of the asymmetric running peripheral sutures. Conclusions: Symmetric running sutures can enhance the suture strength and appears to be a useful technique for increasing the strength of the peripheral suture.

Strength enhancement of the interlocking mechanism in cross-stitch peripheral sutures for flexor tendon repair: biomechanical comparisons by cyclic loading

2009 ◽  
Vol 35 (1) ◽  
pp. 46-50 ◽  
Author(s):  
N. Takeuchi ◽  
H. Mitsuyasu ◽  
S. Hotokezaka ◽  
H. Miura ◽  
H. Higaki ◽  
...  
Keyword(s):  
Fatigue Strength ◽  
Cyclic Loading ◽  
Cyclic Load ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Suture Techniques ◽  
Flexor Tendon Repair ◽  
Strength Enhancement ◽  
The Cross ◽  
Dental Roll

The fatigue strength of three peripheral suture techniques for flexor tendon repair was compared by cyclic loading of repairs in a cotton dental roll tendon model. Thirty pairs of dental roll were sutured using only peripheral sutures with 6-0 polypropylene. An initial cyclic load of 5 N for 500 cycles was applied and increased by 5 N for an additional 500 cycles at each new load until rupture. The fatigue strength of an interlocking cross-stitch suture was 113% greater than a running suture and 36% greater than a standard cross-stitch suture. Interlocking the cross-stitch prevented shortening of the transverse portions under load and appears to be a useful technique for increasing the strength of the peripheral suture.

The biomechanical assessment of gap formation after flexor tendon repair using partial interlocking cross-stitch peripheral sutures

2011 ◽  
Vol 36 (7) ◽  
pp. 584-589 ◽  
Author(s):  
N. Takeuchi ◽  
H. Mitsuyasu ◽  
K. Kikuchi ◽  
T. Shimoto ◽  
H. Higaki ◽  
...  
Keyword(s):  
Fatigue Strength ◽  
Cyclic Load ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Suture Techniques ◽  
Load Testing ◽  
Gap Formation ◽  
Flexor Tendon Repair ◽  
Biomechanical Assessment ◽  
Dental Roll

The gap formation of five core plus peripheral suture techniques for flexor tendon repair was evaluated by cyclic load testing. Fifty pairs of dental roll tendon models were sutured using six-strand Pennington modified Kessler core suture with 4-0 Polypropylene. One-half or three-fourths circumferential interlocking cross-stitch, or three complete circumferential peripheral suture techniques were performed using 6-0 Polypropylene. An initial cyclic load of 10 N for 500 cycles was applied and increased by 5 N for an additional 500 cycles at each new load until rupture. The complete circumferential interlocking cross-stitch had the greatest fatigue strength. The partial circumferential cross-stitches resulted in significantly larger gap formations at both the repaired and unrepaired sides than the complete circumferential sutures, and were also associated with early rupture. The full circumference of the cut tendon must be sutured using an interlocking cross-stitch peripheral suture to improve strength and avoid gap formation.

Factors Affecting the Strength of Flexor Tendon Repair

1992 ◽  
Vol 17 (5) ◽  
pp. 550-552 ◽  
Author(s):  
D. BHATIA ◽  
K. E. TANNER ◽  
W. BONFIELD ◽  
N. D. CITRON
Keyword(s):  
Cyclic Load ◽  
Suture Material ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Tendon Repair ◽  
Factors Affecting ◽  
Full Strength ◽  
Load Tests

The effects of different thicknesses and configurations of core sutures were studied in human cadaveric flexor tendon repairs. Both straight and cyclic load tests were employed. To exploit the full strength of 4/0 suture material, the Kessler repair using four locked single knots would seem to be appropriate.

Incidence of tenolysis and features of adhesions in the digital flexor tendons after multi-strand repair and early active motion

2018 ◽  
Vol 44 (4) ◽  
pp. 354-360 ◽  
Author(s):  
Koji Moriya ◽  
Takea Yoshizu ◽  
Naoto Tsubokawa ◽  
Hiroko Narisawa ◽  
Yutaka Maki
Keyword(s):  
Flexor Tendon ◽  
Full Range ◽  
Tendon Repair ◽  
The Other ◽  
Flexor Digitorum Superficialis ◽  
Flexor Tendon Repair ◽  
Level Of Evidence ◽  
Active Motion ◽  
Active Mobilization ◽  
Flexor Digitorum

We report seven patients requiring tenolysis after primary or delayed primary flexor tendon repair and early active mobilization out of 148 fingers of 132 consecutive patients with Zone 1 or 2 injuries from 1993 to 2017. Three fingers had Zone 2A, two Zone 2B, and two Zone 2C injuries. Two fingers underwent tenolysis at Week 4 or 6 after repair because of suspected repair rupture. The other five fingers had tenolysis 12 weeks after repair. Adhesions were moderately dense between the flexor digitorum superficialis and profundus tendons or with the pulleys. According to the Strickland and Tang criteria, the outcomes were excellent in one finger, good in four, fair in one, and poor in one. Fingers requiring tenolysis after early active motion were 5% of the 148 fingers so treated. Indications for tenolysis were to achieve a full range of active motion in the patients rated good or improvement of range of active motion of the patients rated poor or fair. Not all of our patients with poor or fair outcomes wanted to have tenolysis. Level of evidence: IV

Gross and Histological Analysis of Healing After Dog Flexor Tendon Repair with the Teno Fix™ Device

2006 ◽  
Vol 31 (5) ◽  
pp. 524-529 ◽  
Author(s):  
B. W. SU ◽  
F. J. RAIA ◽  
H. M. QUITKIN ◽  
M. PARISIEN ◽  
R. J. STRAUCH ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Weight Bearing ◽  
Tendon Repair ◽  
Tendon Healing ◽  
Full Weight Bearing ◽  
Cast Immobilization ◽  
Flexor Tendon Repair ◽  
The Common ◽  
Flexor Digitorum

The purpose of this study was to examine the in vivo characteristics of the stainless-steel Teno Fix™ device used for flexor tendon repair. The common flexor digitorum superficialis tendon was transected in 16 dogs and repaired with the device. The animals were euthanized at 3, 6, or 12 weeks postoperatively. Difficulties with cast immobilization led nine of 16 animals to be full weight bearing too early, leading to rupture of their repairs. The seven tendons with successful primary repairs (gap <2 mm) underwent histological examination. This in vivo study demonstrates that use of the Teno Fix™ in “suture” of dog flexor tendons did not lead to scarring at the tendon surface, does not cause an inflammatory reaction within the tendon and does not interfere with tendon healing.

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.

Tendons

2011 ◽  
Author(s):  
David Warwick ◽  
Roderick Dunn ◽  
Erman Melikyan ◽  
Jane Vadher
Keyword(s):  
Tendon Rupture ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Tendon Healing ◽  
Extensor Tendon ◽  
Suture Techniques ◽  
Flexor Tendon Repair ◽  
Tendon Suture ◽  
Anatomy And Physiology ◽  
Flexor Tendon Rupture

Anatomy and physiology 392Tendon healing 394Flexor tendon anatomy 396Flexor tendon zones of injury 400Flexor tendon suture techniques 402Flexor tendon repair 404Closed flexor tendon rupture 410Flexor tenolysis 412Flexor tendon reconstruction 414Extensor tendon anatomy 418Extensor tendon repair ...

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