Scientific articleInfluence of Locking Stitch Size in a Four-Strand Cross-Locked Cruciate Flexor Tendon Repair
Section snippets
Materials and Methods
Many ex vivo animal models use porcine deep flexor tendons to investigate tendon repair constructs.2, 7, 16, 17, 18, 19, 20, 21, 22 Although previous investigators confirmed the resemblance of diameters and arrangement of flexor tendons in pig toes with those of human digits,23, 24 we felt the need to define an exact point of dissection to reliably mimic a zone II laceration in humans. Therefore, we dissected 6 forelimbs from adult pigs and re-examined the anatomy of the deep flexor apparatus.
Results
There was no pullout of the core suture. Of 22 repairs, 21 failed by breakage of the core suture at the knot; one failed by breakage of the thread 1 mm adjacent to the knot.
The load to failure was 71.7 N (±11.0 N) for group 1 (2-mm cross-locks) compared with 71.1 N (±11.8 N) for group 2 (4-mm cross-locks). Therefore, we noted no significant difference in load to failure (p = .89) (Fig. 4).
The load to 2-mm gap formation was 55 N (±8.7 N) for group 1 (2-mm cross-locks) compared with 62.2 N (±9.4
Discussion
According to Strickland,27 a well-constructed 4-strand repair in conjunction with a peripheral suture is capable of tolerating light composite grip during the healing period. However, modern early-active rehabilitation regimens may require high repair loads of up to 50 N17, 28 and a trend toward reduced splint usage is recognizable.29 Taking this into consideration and bearing in mind that unavoidable mishaps during the rehabilitation process might require additional repair strength, stronger
References (43)
- et al.
An evaluation of suture materials used in tendon surgery
J Hand Surg
(1989) - et al.
Cross-sectional area and strength differences of fiberwire, prolene, and ticron sutures
J Hand Surg
(2010) - et al.
Biomechanical analysis of the cruciate four-strand flexor tendon repair
J Hand Surg
(1999) - et al.
A biomechanical analysis of a new interlock suture technique for flexor tendon repair
J Hand Surg
(1992) In vitro studies of a new method of flexor tendon repair
J Hand Surg
(1985)- et al.
Flexor tendon repair using a “six strand” method of repair and early active mobilisation
J Hand Surg
(1989) - et al.
Flexor tendon injuries
- et al.
Comparative biomechanical performances of 4-strand core suture repairs for zone II flexor tendon lacerations
J Hand Surg
(2002) - et al.
The role of multiple strands and locking sutures on gap formation of flexor tendon repairs during cyclical loading
J Hand Surg
(2000) - et al.
Effect of suture locking and suture caliber on fatigue strength of flexor tendon repairs
J Hand Surg
(2001)
Comparative biomechanic performances of locked cruciate four-strand flexor tendon repairs in an ex vivo porcine model
J Hand Surg
Effects of locking area on strength of 2- and 4-strand locking tendon repairs
J Hand Surg
Influence of core suture purchase length on strength of four-strand tendon repairs
J Hand Surg
Biomechanical assessment of a new type of flexor tendon repair
J Hand Surg
Changes in tendon strength after partial cut and effects of running peripheral sutures
J Hand Surg
The porcine forelimb as a model for human flexor tendon surgery
J Hand Surg
The effects of freezing on the tensile properties of repaired porcine flexor tendon
J Hand Surg
Flexor tendon forces: in vivo measurements
J Hand Surg
Effect of the cross-sectional area of locking loops in flexor tendon repair
J Hand Surg
Differences between locking loops and grasping loops: effects on 2-strand core suture
J Hand Surg
The mechanical properties of locking and grasping suture loop configurations in four-strand core suture techniques
J Hand Surg
Cited by (0)
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.