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Journal of Hand Surgery (European Volume)
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Articles

The optimum length of the Silfverskiöld circumferential cross stitch

K. M. HIRPARA
P. J. SULLIVAN
B. O’NEILL
M. O’SULLIVAN

From the Department of Trauma and Orthopaedic Surgery and The Department of Plastic and Reconstructive Surgery, Galway Regional Hospitals, Galway, Ireland

Correspondence: K. M. Hirpara, Department of Trauma and Orthopaedic Surgery, Galway University Hospital, Galway, Ireland. E-mail:kie_hirpara{at}hotmail.com.

Three groups of six porcine deep flexor tendons were repaired with a locking loop modified Kessler core suture using 4-0 braided polyester. Silfverskiöld repairs were performed using 6-0 monofilament nylon taking bites 2, 4 and 6 mm from the cut end of the tendon. The repairs were tested to failure and record made of bulking, mode of failure, force to produce a 3 mm gap and the ultimate strength. Data were analysed using one-way ANOVA, with analysis of mode of failure using the Chi-squared test. The 4 mm repairs were significantly stronger than the 2 mm for all parameters but there was no difference between the 4 mm and 6 mm repairs. We feel that optimal repair strength is provided using bites 4 mm from the cut tendon ends. Taking bites further from the cut end has no significant benefits and carries the theoretical risk of increasing the work of flexion.

Key Words: circumferential repair • Silfverskiöld • flexor tendon • tensile testing • length of repair

Journal of Hand Surgery (European Volume), Vol. 34, No. 5, 651-655 (2009)
DOI: 10.1177/1753193409090102
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