Oblique Suture Research Articles

Pullout strength of meniscal repair after cyclic loading: comparison of vertical, horizontal, and oblique suture techniques

This in vitro biomechanical study with cyclic loading compared the pullout strength of vertical, horizontal, and oblique sutures used for meniscal lesion repair. Following repair of vertical longitudinal lesions created in bovine medial menisci, three groups of seven specimens (vertical, horizontal, and oblique sutures) underwent cyclic loading in a randomized test order (5 mm/min, cycling between 5 and 50 N at 1 Hz for 100 cycles) prior to load to failure testing (5 mm/min). Displacement did not differ between groups during cyclic or load to failure testing. Construct stiffness during cyclic testing was superior for the oblique suture (6.9 +/- 1.5 N/mm, P = 0.007) and the vertical suture (6.4 +/- 7 N/mm, P = 0.03) groups compared to the horizontal suture group (4.4 +/- 0.52 N/mm). The oblique suture (171.9 +/- 25.9 N, P < 0.0001) and the vertical suture (145.9 +/- 32.3 N, P = 0.001) groups displayed superior load at failure compared to the horizontal suture group (88.8 +/- 8.2 N). Construct stiffness during load to failure testing did not differ between groups. Suture rupture was the failure mode for all specimens of the oblique suture group. Suture rupture was the failure mode for 57% (4/7) of the vertical suture group with the remaining specimens (3/7, 43%) failing from intact suture pullout through meniscal tissue. All horizontal suture group specimens failed by intact suture pulling through meniscal tissue. With comparable stiffness during cyclic testing, comparable load at failure as vertical sutures, and less evidence of intact suture pullout through the meniscus, an oblique suture technique may combine the beneficial characteristics of vertical (superior biomechanical strength) and horizontal (ease of application, longer sutures with a tendency to cover a larger meniscal tissue area) suture-repair techniques.

The seymouriamorph tetrapod Ariekanerpeton sigalovi from the Lower Permian of Tadzhikistan. Part I: Cranial anatomy and ontogeny

ABSTRACTRedescription of the cranial anatomy of Ariekanerpeton sigalovi (Seymouriamorpha: Discosauriscidae; Lower Permian, Tadzhikistan) highlights new diagnostic features which permit a new skull reconstruction and revised diagnosis. The largest Ariekanerpeton specimens differ from like-sized Discosauriscus, a second member of Discosauriscidae, in showing: oblique anterior margin of tabular ornamented surface; acute, elongate posterolateral corner of supratemporal; postorbital ventrolateral ramus with small anteroventral process and forming oblique suture with jugal dorsomedial ramus; jugal posterior ramus tapering rearward, forming subhorizontal suture with quadratojugal; weak ventral sculpture lateral to pterygoid articular recess; parasphenoid subrhomboidal, with lightly sculptured anterior wedge-like process; more densely arranged denticle rows on top of low radiating ridges on pterygoid palatal ramus. Gill filaments occur in specimens with skull lengths of up to 30 mm. Detailed examination of ontogenetic changes in Ariekanerpeton and comparisons with other seymouriamorphs are presented.

Effects of direction of tendon lacerations on strength of tendon repairs

Purpose: We compared the tensile strength of different repair configurations on tendons with oblique and transverse lacerations. Method: Seventy-two fresh pig flexor tendons were divided randomly and repaired using the modified Kessler, the cruciate, or the 4-strand Massachusetts General Hospital (MGH) repair methods. The tendons were lacerated either transversely or obliquely. They were repaired with conventional and oblique suture repairs. The 2-mm gap formation force and ultimate strength were determined as biomechanical performance for each repair. Results: The gap formation and ultimate strength of the tendons vary with orientations of tendon lacerations and suture methods. In the tendons repaired with the modified Kessler or the cruciate methods, the 2-mm gap formation and ultimate strength of obliquely cut tendons were significantly lower than those of transversely cut tendons. The obliquely placed modified Kessler or cruciate sutures significantly improved the repair strength in the tendons with an oblique laceration. In the tendons repaired with the MGH method, no statistical differences were found in the repair strength of obliquely and transversely lacerated tendons. Conclusions: The direction of tendon lacerations affects strength of certain repair configurations. The nonlocking modified Kessler or the cruciate tendon repairs are weakened considerably when the tendon laceration is oblique but their mechanical performance is strengthened by re-orienting the repair strands to lie parallel to the laceration. The cross-locked configuration of the MGH repair is not affected by the obliquity of the tendon laceration. (J Hand Surg 2003;28A:237-242. Copyright © 2003 by the American Society for Surgery of the Hand.)

Strabismus surgery in congenital third nerve palsy

BACKGROUND. Congenital third nerve palsy is a rare condition that usually presents with a large-angle incomitant strabismus and is often associated with ptosis and amblyopia. METHODS. We present the results of strabismus surgery in seven consecutive patients. RESULTS. All the palsies developed before the age of 6 months and the age at surgery ranged from 3 to 24 years. The operations performed included horizontal recti resection/recession (7), supra-placement of the insertions (6), superior oblique weakening (4) and traction sutures (4). The preoperative and postoperative horizontal deviations consisted of seven exotropias and one esotropia due to a combined sixth and partial third nerve palsy. The preoperative vertical deviation consisted of 7 hypotropias and one hypertropia; postoperatively, 5 remained hypotropic and 2 were hypertropic. All patients underwent ptosis surgery. CONCLUSION. Patients with congenital third nerve palsy often achieve reasonable cosmesis with strabismus and ptosis surgery.

Prosthetic Bypass and Flow Reversal in the Dissecting Thoraco-Abdominal Aortic Aneurysm

In 1981 Carpentier and Co-workers introduced an alternative surgical procedure for great dissecting thoraco-abdominal aortic aneurysms, departing from the resection and the orthotopic implantation of a prosthesis (graft inclusion technique). Compression of the aneurysmatic false lumen from the inside under stepwise thrombosis of the aneurysmal sac with conservation of the main arterial origins was achieved by prosthetic bypass of the diseased vascular part and a flow reversal in the dissected aortic region by an oblique suture across the aortic lumen after the origin of the left subclavian artery. This procedure, distinguished by rather little effort and few complications (bleeding, ischaemic spinal cord damage) is described for all stages of dissecting thoracal aortic aneurysms. In the last 2 years this operation was performed in our department on 4 patients (1 m. 3 f) suffering from an acute dissecting thoraco-abdominal aortic aneurysm (Stanford type B). 2 patients died in the early postoperative period, one from a redissection close to the proximal anastomosis, the other due to the critical cardiac situation. 2 patients could be followed up postoperatively 10 and 27 months. In both cases no signs of minor perfusion of the spinal cord, the kidneys, or the mesenterial organs were observed. In both cases a partial thrombosis of the aneurysmal sac with intact blood stream to the major vessels in these regions could be demonstrated by sonography, angiography or DSA, and computer tomography. The concept of flow reversal proved to be an alternative to major resection procedures.

Management of the Penile Shaft Skin in Hypospadias Repair: Alternative to Byars’ Flaps

Two variations for resurfacing the penile shaft skin after repair of hypospadias defects are described. These techniques have been used in an effort to prevent some of the skin tags, tension at the penoscrotal angle, and oblique suture lines that may occur with the traditional Byars' flaps.

Management of the penile shaft skin in hypospadias repair: Alternative to Byars' flaps

Two variations for resurfacing the penile shaft skin after repair of hypospadias defects are described. These techniques have been used in an effort to prevent some of the skin tags, tension at the penoscrotal angle, and oblique suture lines that may occur with the traditional Byars' flaps.

CONSIDERAÇÕES SOBRE A GEOLOGIA DA REGIÃO ENTRE PORTO NACIONAL E IPUEIRAS, GO

The present study carried out in the area between Porto Nacional and Ipueiras (northern Goias) allowed to recognize several steps of its geologic evolution. 1. The Porto Nacional complex, Morro do Aquiles Formation, and Matanca Suite essemble the oldest rocks of the area. They represent strongly modified mafic/ultramafic, varied granitold, and supracrustal rocks, which were sheared, disrupted, and imbricated by progressive non-coaxial deformation, and metamorphosed and migmatized at high-amphibolite facies conditions. Taking into account the regional information, lhe deformation and metamorphic processes are linked to an event of collision tectonics of two crustal blocks (Brasilia and Araguacema), involving movements towards N-330 and oblique suture with N-30 direction. This event is presumed lo be of Late Archean (Jequie) age. 2. Besides these features, the mentioned rocks were also affected by younger transcurrent ductile shear zones, mainly with N-30 trend, which are interpreted as due lo mass rotation during the Early Proterozoic (transamazonian). 3. The granitoid of the Lajeado Suite (1.8 Ga) intruded those rocks and are viewed as anorogenic bodies. like acid intrusions of the eastem Amazonian region. 4. During the Middle Proterozoic-Ordovician interval, an intricated fault system was formed , mostly trending N-30 (Transbrasiliano Lineament). Also, an ensialic basin could develop and the filling rocks were weakly folded and metamorphosed (Natividade Group). 5. The Parnaiba Basin developed during the Ordovician-Jurassic interval in a stable tectonic setting: only the oldest sedimentary formations (Serra Grande and Pimenteiras ) are present in lhe area . 6. Gravity faults and diabase dykes of Jurassic-Cretaceous age formed during the South American Reactivation event. 7. The Cenozoic has been time of tectonic stability and lhe sediments of this age are correlative to morphogenetic episodes.

Modern pterobranchs: observations on their behaviour and tube building

Summary There is a considerable difference in the ultrastructure of fusellar tissue between fossil graptolites and modern pterobranchs. The phylogenetic significance of these differences is uncertain. It was thought that the ultrastructure of the earliest, and therefore probably the simplest, stage of formation of the pterobranch prosiculum might provide additional relevant clues. The larva escapes from the original dome-shaped seal by producing a hole, and immediately produces a series of fuselli around the aperture. The zooid uses the cephalic shield to construct the tube. The size of the original fuselli is very variable, but soon achieves adult size. The fuselli are very similar to those of adult erect tubes, and have oblique sutures. There is much extraneous material incorporated into the wall. It is proposed that the fibrils of the stroma of the coenecium somehow mature after they have been secreted. Histochemical tests suggest that the stroma contains a considerable amount of acid and sulphated mucopolysaccharides. Tests for chitin and keratin have been uniformly negative. Similar positive histochemical reactions have been achieved on the cephalic shield. Adult tube building and repair are reported for the first time.

TWO NEW SPECIES OF ELEODES FROM THE PACIFIC COAST REGION (COLEOPTERA: TENEBRIONIDAE.)

The following new species of Eleodes have recently, come to hand and are described as follows:Eleodes indentata n. sp. (Subgenus Blapylis Horn.)Female—From ovate, about twice as long as wide, widest across middle of the elytra. Color deep black, luster polisheci ancl shining.Head slightly widest across the eyes, before the post-ocular line a little more than twice as wide as long; sides of the front scarcely as prominent as the eyes, arcuately convergent to the oblique sutures and there broadly sinuate; sides of the epistoma straight and convergent, angles evenly. rounded, apex broadly sinuate : frons feebly convex, s1ight1y and broadly impressed within the moderatc supra-antennal convexities, very densely punctate, punctures coarse and more or less coalescent, smaller on the occiput. Labmrum transverse, densely punctete in apical one-half, thence to base smooth and very sparsel punctate.

I.—A large Labyrinthodont Tooth from the Upper Karroo Beds of Wonderboom, near Burghersdorp

This vomerine tooth was found by Dr. D. R. Kannemeyer when resident at Burghersdorp. It is the only evidence of the dentition of the animal known, and is interesting as being of much larger size than any Labyrinthodont teeth hitherto found in South Africa, though smaller than the large teeth of Mastodonsaurus giganteus from the Keuper of Würtemburg. Its presumed position on the palate is based upon the anchylosis of the tooth with a bone which shows a flat oblique suture at the base of the crown. This sutural surface is usual on vomerine teeth, and indicates that the tooth was directed downward, outward, and a little backward.