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Evaluation of Simple and Looped Suture and New Material for Flexor Tendon RepairFrom the Department of Orthopaedic Surgery, Loma Linda University, Loma Linda, CA, USA Correspondence: Montri D. Wongworawat, MD, Department of Orthopaedic Surgery, Loma Linda University, 11406 Loma Linda Drive, Suite 218, Loma Linda, CA 92354, USA. Tel.: +1 909-558-6444; fax: +1 909-558-6118. E-mail:wongworawat{at}gmail.com. Flexor tendon repair strength is proportional to the number of suture strands crossing the repair site but it is not clear if each strand needs to result from a separate pass through the tendon. We examined whether one throw of looped suture across a repair site equals two separate throws of suture and whether fewer passes with stronger material such as Fiberwire is equivalent to more passes with a comparatively weaker material such as Supramid. When evaluating the repairs for force required to generate a 2 mm gap and for gap formed at the instant prior to failure, looped suture cannot substitute for two separate passes of suture (Supramid Kessler looped vs. separate passes, 14 N vs. 35 N and 8.8 mm vs. 4.1 mm, respectively; Fiberwire Kessler looped vs. separate passes, 25 N vs. 43 N and 7.6 mm vs. 4.6 mm, respectively; all p<0.05). Two-stranded Fiberwire Kessler repair equalled four-stranded cruciate repair with Supramid for all tested parameters (force at 2 mm gap: 17 N vs. 22 N, respectively; force at failure: 42 N vs. 46 N; and gap formed prior to instant of failure: 6.9 mm vs. 5.6 mm; all p>0.05).
Key Words: tendon repair • suture • looped • Fiberwire • Kessler • cruciate
This version was published on June
1, 2009 Journal of Hand Surgery (European Volume), Vol. 34, No. 3,
329-332 (2009) |
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