scholarly journals Flexor tendon repair: a comparative study between a knotless barbed suture repair and a traditional four-strand monofilament suture repair

2013 ◽  
Vol 39 (1) ◽  
pp. 40-45 ◽  
Author(s):  
C. W. Joyce ◽  
K. E. Whately ◽  
J. C. Chan ◽  
M. Murphy ◽  
F. J. O’Brien ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Biomechanical Testing ◽  
Tendon Repair ◽  
Barbed Suture ◽  
Suture Repair ◽  
Flexor Tendon Repair ◽  
Cross Sectional ◽  
Pulley System ◽  
Suture Group

We compared the tensile strength of a novel knotless barbed suture method with a traditional four-strand Adelaide technique for flexor tendon repairs. Forty fresh porcine flexor tendons were transected and randomly assigned to one of the repair groups before repair. Biomechanical testing demonstrated that the tensile strengths between both tendon groups were very similar. However, less force was required to create a 2 mm gap in the four-strand repair method compared with the knotless barbed technique. There was a significant reduction in the cross-sectional area in the barbed suture group after repair compared with the Adelaide group. This would create better gliding within the pulley system in vivo and could decrease gapping and tendon rupture.

A Novel Flexor Tendon Repair Device: Biomechanical Testing in Cadaver Tendon and In-Vivo Verification Using a Rabbit Model

2013 ◽  
Author(s):  
Shawn P. Reese ◽  
Eric N. Kubiak
Keyword(s):  
Flexor Tendon ◽  
Biomechanical Testing ◽  
Rabbit Model ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Suture Repair ◽  
Flexor Tendon Repair ◽  
Tissue Ischemia ◽  
Flexor Tendons

The digital flexor tendons of the hand, including the flexor digitorum profundus (FDP), are responsible for enabling finger flexion and gripping. Injuries involving a partial or complete laceration to the digital flexor tendons are common and associated with a high incidence of morbidity [1]. The current state of the art for flexor tendon repair is the use of two or more core sutures in combination with an epitendinous circumferential suture. There are inherent limitations to suture based methods, including a high level of skill required to perform the suture repair, increased surgical time and the tendency for sutures to strangulate the tissue (creating local tissue ischemia). Suture based repairs often result in sub-optimal clinical outcomes, with reported failure rates ranging from 4%–10% [2]. In order to address these limitations, a novel non-suture based repair device has been developed. The objectives of this study were twofold. The first objective was to determine the gapping strength of the device in cadaver FDP tendons so that comparisons could be made to values reported in the literature for suture based repairs. The second objective was to determine the in-vivo capability of the device to facilitate tendon repair, relative to a suture control, in a rabbit model at a five week time point.

Flexor Tendon Repair With a Knotless, Bidirectional Barbed Suture: An In Vivo Biomechanical Analysis

2015 ◽  
Vol 40 (5) ◽  
pp. 963-968 ◽  
Author(s):  
Grady E. Maddox ◽  
Jonathan Ludwig ◽  
Eric R. Craig ◽  
David Woods ◽  
Aaron Joiner ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Biomechanical Analysis ◽  
Barbed Suture ◽  
Flexor Tendon Repair

scholarly journals Does Barbed Suture Repair Negate the Benefit of Peripheral Repair in Porcine Flexor Tendon?

Hand ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. 479-483
Author(s):  
Alan Sull ◽  
Serkan Inceoglu ◽  
Montri D. Wongworawat
Keyword(s):  
Tensile Strength ◽  
Load Distribution ◽  
Suture Material ◽  
Flexor Tendon ◽  
Biomechanical Testing ◽  
Tendon Repair ◽  
Barbed Suture ◽  
Suture Repair ◽  
Maximum Tensile Strength ◽  
Minimal Data

Background: Advances in suture material and geometry have fueled interest in barbed suture tenorrhaphy. Theoretically, barbed suture allows better load distribution, smoother gliding under pulleys, and improved tendon blood flow. Minimal data exist on whether barbed tendon repair may benefit from supplementation by a peripheral stitch. The purpose of this study is to determine whether peripheral suture repair increases gap resistance in both conventional and barbed core repairs, increases maximum tensile strength, and fails before or after the core repair. Methods: Porcine flexor tendons were harvested and assigned randomly into 4 groups of 10 of varying suture constructs (3-0 PDS™ or 3-0 V-Loc 180™ core with or without peripheral 5-0 Vicryl™ repair). Core repairs were performed using a modified 4-strand cruciate repair. A servohydrolic tester was used for biomechanical testing of linear 2-mm gap resistance and maximum tensile strength. Results: Peripheral repair improved 2-mm gap resistance in all repairs, regardless of core suture type, conventional (173% increase) or barbed (204% increase). No change in the maximum tensile strength was found in either core suture type with peripheral repair. Peripheral repairs always failed before core repairs, at a significantly higher load of 74.2 ± 20.4 N in barbed versus 57.8 ± 12.2 N ( P = .04) in conventional core repairs. Conclusions: The addition of peripheral repair improved gap resistance but not ultimate tensile strength in both conventional and barbed flexor tendon repairs in linear testing. The 4-strand cruciate flexor tendon repairs using barbed suture may require peripheral repair to withstand physiologic loads, as core repair alone using barbed suture was insufficient.

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.

Effects of Increased In Vivo Excursion on Digital Range of Motion and Tendon Strength following Flexor Tendon Repair

2000 ◽  
Vol 82 (3) ◽  
pp. 68
Author(s):  
Matthew J. Silva ◽  
Michael D. Brodt ◽  
Martin I. Boyer ◽  
Timothy S. Morris ◽  
Haralambos Dinopoulos ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Tendon Repair

Effects of Increased In Vivo Excursion on Digital Range of Motion and Tendon Strength following Flexor Tendon Repair

2000 ◽  
Vol 82 (8) ◽  
pp. 56
Author(s):  
Matthew J. Silva ◽  
Michael D. Brodt ◽  
Martin I. Boyer ◽  
Timothy S. Morris ◽  
Haralambos Dinopoulos ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Tendon Repair

The Direct Midlateral Approach with Lateral Enlargement of the Pulley System for Repair of Flexor Tendons in Fingers

1996 ◽  
Vol 21 (4) ◽  
pp. 463-468 ◽  
Author(s):  
A. MESSINA ◽  
J. C. MESSINA
Keyword(s):  
Flexor Tendon ◽  
Skin Flap ◽  
Tendon Repair ◽  
Tendon Sheath ◽  
Flexor Tendon Repair ◽  
Anterior Compartment ◽  
Pulley System ◽  
Neurovascular Pedicle ◽  
Anchoring System ◽  
Palmar Skin

The direct midlateral approach and the lateral enlarging procedure of the pulley system have been utilized in our service since 1972. The incision runs directly behind the neurovascular pedicle, which is left in the palmar skin flap of the anterior compartment of the finger, in order to ensure its blood supply and sensibility. The transverse digital lamina of Landsmeer’s skin anchoring system and Cleland’s ligament are preserved and are used to perform a lateral enlargement of the pulleys after tendon repair. The technique allows wide surgical exposure of the digital fibro-osseous tunnel, enlargement and reconstruction of the pulley system and tendon sheath, flexor tendon repair (using the technique of choice) and reduces postoperative impingement in zone 2.

scholarly journals Tensile Strength of Flexor Tendon Repair Using Barbed Suture Material in a Dynamic Ex Vivo Model

2016 ◽  
Vol 04 (01) ◽  
pp. 16-20 ◽  
Author(s):  
Philip Zeplin ◽  
M. Henle ◽  
R. Zahn ◽  
R. Meffert ◽  
K. Schmidt
Keyword(s):  
Tensile Strength ◽  
Suture Material ◽  
Flexor Tendon ◽  
Ex Vivo ◽  
Tendon Repair ◽  
Barbed Suture ◽  
Ex Vivo Model ◽  
Flexor Tendon Repair
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