title: Effects of direction of tendon lacerations on strength of tendon repairs.
abstract: OBJECTIVE
  We compared the tensile strength of different repair configurations on tendons with oblique and transverse lacerations.
  
  
  METHODS
  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.
authors.affiliation: Hand Surgery Research Center, Department of Hand Surgery, Affiliated Hospital of Nantong Medical College, Nantong, Jiangsu, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Tan
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.forename: Yan
authors.initials: Y
authors.lastname: Xu
authors.forename: Jin Bo
authors.initials: JB
authors.lastname: Tang
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D001696:Biomechanical Phenomena; D022125:Lacerations; D013536:Suture Techniques; D013552:Swine; D013708:Tendon Injuries / Q000601:surgery*; D013718:Tensile Strength