Abstract
The choices of suture methods used to secure the end of a small-caliber tendon with a combination of suture materials passing through and looping around the tendon are not well documented. A secure stitch-tendon unit may be an important factor in preserving muscle function, by facilitating healing without gapping or failure. Five types of suture methods utilizing four or fewer passes through the tendon end were mechanically tested on 178 canine flexor digitorum profundus tendons. An Instron apparatus was used to test the load to failure. The single and double clove-hitch suture methods demonstrated improved repair strength when compared with the three other methods studied in this small-caliber canine tendon model. The single and double clove-hitch suture method better secured the end of a small-caliber tendon compared with other methods. The single (pull-out) and double (non-pull-out) clove-hitch suture methods are reliable alternatives for the repair of small-caliber tendons.
Highlights
MethodsFive types of suture methods utilizing four or fewer passes through the tendon end were mechanically tested on 178 canine flexor digitorum profundus tendons
The choices of suture methods used to secure the end of a small-caliber tendon with a combination of suture materials passing through and looping around the tendon are not well documented
The single and double clove-hitch suture methods demonstrated improved repair strength when compared with the three other methods studied in this small-caliber canine tendon model
Summary
Five types of suture methods utilizing four or fewer passes through the tendon end were mechanically tested on 178 canine flexor digitorum profundus tendons. The average width of the tendons was 4.3 mm, with a range from 3.5 to 4.5 mm, and the average depth was 2.6 mm, with a range from 2.0 to 3.0 mm These measurements were obtained by using a tumor meter calibrated to 0.1 mm (U.S Patent 423960; BHS International, Crofton, Maryland) and a magnifying glass apparatus. The specimens were wrapped in normal saline solution-soaked gauze and placed in plastic zip lock bags They were stored in a refrigerator at 2°C for up to three days. 4% of the specimens were stored in a freezer at 270°C for up to seven days These tendons were thawed over a twenty-four-hour period in a refrigerator and were warmed to 37°C prior to biomechanical testing
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