title: Biomechanical assessment of suture techniques used for tendon repair.
abstract: OBJECTIVE
  The aim of this study was to assess different tendon suture techniques from the perspectives of both tensile strength and early active mobilization.
  
  
  METHODS
  In this study, we implemented repairs on 40 flexor digitorum profundus (FDP) tendons, acquired from fresh frozen cadavers. The tendons were divided into 5 groups of 8 tendons each. We applied the 2-strand modified Kessler suture technique in the first group, the 4-strand Strickland suture technique in the second group, the 4-strand modified Kessler (without epitenon suture) suture technique in the third group, and the 4-strand modified Kessler (with epitenon sutures) suture technique in the fourth group. The remaining 8 intact tendons were set aside as the control group. The strength of the different tendon suture techniques were measured using the Instron(®) device.
  
  
  RESULTS
  The average tolerance strength of the first group was determined as 39.89 ± 9.65 Newtons (N), the average tolerance strength of the second group was 39.64 ± 9.14 N, the average tolerance strength of the third group was 50.29 ± 11.24 N, the average tolerance strength of the fourth group was 54.47 ± 6.83 N, and the average tolerance strength of the control group was 119 ± 17.59 N. The tensile strength of the fourth group was significantly higher (p<0.05) than the first group, and the tensile strength of the third group was also significantly higher (p<0.05) than the first group. No significant difference was observed between the tensile strengths of the second and first groups (p>0.05).
  
  
  CONCLUSIONS
  According to our findings, the tensile strength of 4-strand sutures, with or without epitenon sutures, are significantly higher than the tensile strength of 2-strand sutures. All suture techniques applied had sufficient tensile strength to promote early mobilization.
authors.affiliation: Manus - Hand Group, İstanbul, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Yalçin
authors.forename: M Selman
authors.initials: MS
authors.lastname: Demirci
authors.forename: Mehmet
authors.initials: M
authors.lastname: Alp
authors.forename: Salih Murat
authors.initials: SM
authors.lastname: Akkin
authors.forename: Burak
authors.initials: B
authors.lastname: Sener
authors.forename: Jürgen
authors.initials: J
authors.lastname: Koebke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D013536:Suture Techniques; D013710:Tendons / Q000601:surgery*; D013718:Tensile Strength