Flexor tendon repair using the two-strand side-locking loop technique to tolerate aggressive active mobilization immediately after surgery.
BACKGROUND
Early mobilization after tendon repair decreases adhesion formation and improves repair-site strength. We investigated whether the two-strand side-locking loop technique would tolerate aggressive active mobilization immediately after surgery.


METHODS
Twelve flexor digitorum profundus tendons of the porcine forelimbs were sutured by the two-strand side-locking loop technique with a cross-stitch epitendinous repair (Group A), and by the 8-strand repair method with a simple running suture (Group B). Gaps and residual tensile strength after cyclic loadings of 3-50 N (for 10,000 rounds) were measured.


RESULTS
Gaps after cyclic loading in Group A were 0.5+/-0.3 and 1.2+/-0.8 mm while those in Group B were 3.5+/-0.8 and 5.2+/-1.2 mm at 3 and 50 N, respectively. In addition, the respective residual tensile strength of Groups A and B were 207.1+/-15.2 and 84.2+/-18.3N.


CONCLUSIONS
A combination of the two-strand side-locking loop technique with cross-stitch epitendinous repair served as the optimum suture method in establishing safe and early active mobilization without the aid of a specialized rehabilitation staff.
Kuwata
Suguru
S
Department of Orthopedic Surgery, Shimane University School of Medicine, 89-1, Enya, Izumo, Shimane 693-8501, Japan. labo@med.shimane-u.ac.jp
Mori
Ryuji
R
Yotsumoto
Tadahiko
T
Uchio
Yuji
Y
D000818:Animals; D001696:Biomechanical Phenomena; D004285:Dogs; D004867:Equipment Design; D005552:Forelimb / Q000473:pathology; D006230:Hand Injuries / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D011091:Polyesters / Q000737:chemistry; D020959:Polyethylene / Q000737:chemistry; D012046:Rehabilitation; D013536:Suture Techniques; D013537:Sutures; D013552:Swine; D013708:Tendon Injuries / Q000503:physiopathology / Q000601:surgery*; D013710:Tendons / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D013718:Tensile Strength; D016474:Weight-Bearing / Q000502:physiology
D011091:Polyesters; D020959:Polyethylene