title: Mechanical properties of various circumferential tendon suture techniques.
abstract: We evaluated the mechanical properties of six different circumferential tendon sutures with a variable number of suture strands. Seventy-two human cadaver flexor profundus tendons were cut and repaired using only a 6/0 polypropylene circumferential suture. The six running suture techniques were: Simple; Simple-locking; Lembert; Halsted; Cross-stitch; Lin-locking; using 10, 14 and 18 suture passes. The increased suture passes increased both tensile and gap strengths. The tensile strength of the Lin-locking technique (29 to 63 N) was significantly stronger than the others, followed by Cross-stitch (27 to 38 N), Halsted (21 to 27N), Lembert (20 to 27N), Simple (11 to 22 N) and Simple-locking (10 to 17 N). The gap strength values were between 3 to 14N, with no significant differences between the techniques. The resistance to gliding, as measured by work of flexion, was not affected by the number of strands. However, the Lin-locking significantly increased the resistance to gliding (33-36%) compared to the other techniques (6-21%); there were no significant differences between these five techniques.
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
authors.forename: H
authors.initials: H
authors.lastname: Kubota
authors.forename: M
authors.initials: M
authors.lastname: Aoki
authors.forename: D L
authors.initials: DL
authors.lastname: Pruitt
authors.forename: P R
authors.initials: PR
authors.lastname: Manske
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D006230:Hand Injuries / Q000503:physiopathology / Q000601:surgery*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D011183:Postoperative Complications / Q000503:physiopathology; D013529:Surgical Wound Dehiscence / Q000503:physiopathology*; D013536:Suture Techniques; D013708:Tendon Injuries / Q000503:physiopathology / Q000601:surgery*; D013718:Tensile Strength; D016474:Weight-Bearing / Q000502:physiology