Effect of circumferential sutures on tensile and gap strength of repaired canine flexor tendons

Abstract

Sixty-four dog cadaver flexor digitorum profundus tendons in zone 2 were lacerated and repaired with a simple or a cross-stitch peripheral circumferential suture in combination with two-, four-, or six-strand core sutures. The tensile and gap strengths were compared. The range of tensile strengths with the cross-stitch circumferential suture in combination with various core suture techniques (4.28-9.37kgf) was significantly higher than the range of values for the simple circumferential suture and similar core suture techniques (1.70-4.98 kgf). The tensile strength with two-strand core suture plus the cross-stitch circumferential suture (5.29 kgf) was as great as that of the six-strand core suture plus the simple circumferential suture (4.98kgf). Increased gap strength values were also observed with the cross-stitch (1.11-3.19kgf) compared to the simple (0.84 to 1.76kgf) circumferential sutures. The cross-stitch circumferential suture had a mechanical advantage in flexor tendon repair compared to the simple circumferential suture.