title: Effect of suture material on gap formation and failure in type 1 FDP avulsion repairs in a cadaver model.
abstract: BACKGROUND
  An in vitro cyclical testing simulating a passive mobilisation protocol was used to compare repair of flexor digitorum profundus tendon with modified-Bunnell two-strand pullout technique using a monofilament (Prolene), braided polyester (Ethibond) and a synthetic polyfilament ensheathed by caprolactan (Supramid) sutures.
  
  
  METHODS
  Eighteen fresh-frozen cadaveric fingers were randomly divided into three repair groups (n = 6); modified-Bunnell technique with 3/0 Prolene, Ethibond or Supramid. After repair, specimens were cyclically loaded from 2 to 15N at 5N/s, for a total of 500 cycles. Gap formation at the tendon-bone interface was assessed every 100 cycles. Samples were tested to failure at the completion of 500 cycles.
  
  
  RESULTS
  All sutures held in all specimens during cyclic testing. The gap formation after 500 cycles was greatest with Prolene suture (6.8 mm, SD 1.2) followed by Supramid suture (4.0 mm, SD 1.1) and Ethibond suture (1.7 mm, SD 1.7) (P < 0.05). Repairs with Supramid displayed higher failure load (52.7 N, SD 5.5) as compared to Prolene (37.6N, SD 4.7) (P = 0.001) but not compared to Ethibond (44.9 N, SD 7.1). The failure loads between Prolene and Ethibond did not differ (P = 0.130).
  
  
  CONCLUSIONS
  Gap formation with Ethibond was significantly lower compared to Supramid and Prolene. The four strand nature of the Supramid repair was superior to Prolene but did not differ compared to Ethibond with respect to failure load. Prolene is the least favourable suture when considering gap formation and failure load, while Ethibond is the most favourable.
authors.affiliation: Orthopaedic Research Laboratories, University of New South Wales, Prince of Wales Hospital, Edmund Blacket Building, Randwick, NSW 2031, Australia.
authors.forename: F B
authors.initials: FB
authors.lastname: Schreuder
authors.forename: P J
authors.initials: PJ
authors.lastname: Scougall
authors.forename: E
authors.initials: E
authors.lastname: Puchert
authors.forename: F
authors.initials: F
authors.lastname: Vizesi
authors.forename: W R
authors.initials: WR
authors.lastname: Walsh
mesh_terms: D000368:Aged; D002102:Cadaver; D004868:Equipment Failure; D019544:Equipment Failure Analysis; D005383:Finger Injuries / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D066298:In Vitro Techniques; D008422:Materials Testing; D019651:Plastic Surgery Procedures / Q000295:instrumentation*; D013312:Stress, Physiological; D013537:Sutures; D013708:Tendon Injuries / Q000503:physiopathology* / Q000601:surgery*; D013718:Tensile Strength; D017211:Treatment Failure; D016896:Treatment Outcome