A loop-tendon suture for tendon transfer or graft surgery.
OBJECTIVE
We present a loop-tendon suture technique that was designed for easy tension adjustment and early postoperative rehabilitation in tendon transfer or graft surgeries. This study tested the biomechanical strength of the loop-tendon suture by using chicken flexor tendons and we report the preliminary clinical results.


METHODS
We tested the ultimate strength of the loop-tendon suture against the end-weave suture technique in chicken flexor tendons. Forty flexor digitorum longus tendons of chickens were divided into 2 groups according to the suture technique, loop-tendon suture and end-weave suture groups, and then were subjected to linear loading in a tensile load testing machine. From 2000 to 2002 we performed 27 tendon transfer surgeries clinically, including 4 interpositional tendon grafts in 15 patients, using this technique followed by immediate passive motion exercise after surgery. The mean follow-up time was 20 months.


RESULTS
The ultimate tensile load of chicken flexor tendons was 31 +/- 6 N for the loop-tendon suture group and 23 +/- 8 N for the end-weave suture group, and the difference was statistically significant. Clinically, 6 patients with an extensor indicis proprius to an extensor pollicis longus transfer showed more than good results in the Geldmacher scheme. Three patients with an extensor indicis proprius to a central tendon transfer achieved proximal interphalangeal extension of less than 15 degrees of extension lag. One patient with a flexor digitorum profundus reconstruction obtained total active motion of 210 degrees. The 5 patients with triple transfers for radial nerve palsy showed more than neutral extension of the wrist and metacarpal joint. There were no tendon ruptures.


CONCLUSIONS
The loop-tendon suture method has greater strength than the conventional end-weave technique, and can be used for secondary tendon reconstruction surgery with favorable clinical outcomes.


METHODS
Therapeutic IV.
Kim
Sae Hoon
SH
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
Chung
Moon Sang
MS
Baek
Goo Hyun
GH
Lee
Young Ho
YH
Lee
Sanglim
S
Gong
Hyun Sik
HS
D000328:Adult; D000368:Aged; D000818:Animals; D002645:Chickens; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000601:surgery; D013536:Suture Techniques; D013709:Tendon Transfer; D013710:Tendons / Q000637:transplantation*; D013718:Tensile Strength; D014182:Transplantation, Autologous