Abstract
OBJECTIVE:In this work, we attempted to develop a modified single-knot Kessler-loop lock suture technique and compare the biomechanical properties associated with this single-knot suture technique with those associated with the conventional modified Kessler and interlock suture techniques.METHODS:In this experiment, a total of 18 porcine flexor digitorum profundus tendons were harvested and randomly divided into three groups. The tendons were transected and then repaired using three different techniques, including modified Kessler suture with peritendinous suture, interlock suture with peritendinous suture, and modified Kessler-loop lock suture with peritendinous suture. Times required for suturing were recorded and compared among groups. The groups were also compared with respect to 2-mm gap load, ultimate failure load, and gap at failure.RESULTS:For tendon repair, compared with the conventional modified Kessler suture technique, the interlock and modified Kessler-loop lock suture techniques resulted in significantly improved biomechanical properties. However, there were no significant differences between the interlock and modified Kessler-loop lock techniques with respect to biomechanical properties, gap at failure, and time required.CONCLUSIONS:The interlock and modified Kessler-loop lock techniques for flexor tendon sutures produce similar mechanical characteristics in vitro.
Highlights
Flexor tendon injury is a common clinical trauma
The choice of tendon repair technique plays an important role in tendon healing and postoperative functional exercise
Two-millimeter Gap Load Two-millimeter gap load is an important index for evaluating resistance strength after tendon repair
Summary
Postoperative active functional exercise can effectively reduce the formation of local adhesions and edema and facilitate sliding function of the tendon, thereby promoting endogenous tendon healing [1,2]. The choice of tendon repair technique plays an important role in tendon healing and postoperative functional exercise. The ideal repair should be easy to perform; provide sufficient strength for healing (over 30 N) [3], which can ensure minimal interference with tendon vascularity; and involve secure suture knots and smooth junction of tendon ends. Various suture techniques [4,5] have been proven to exhibit sufficient resistance to gap formation. Many techniques are demanding with respect to surgical experience and suturing skills. It is essential to explore a relatively simple tenorrhaphy with good mechanical strength
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