title: A biomechanical comparison of 3 loop suture materials in a 6-strand flexor tendon repair technique.
abstract: OBJECTIVE
  The braided polyblend (FiberWire) suture is recognized for its superiority in tensile strength in flexor tendon repair. The purpose of this study was to compare the biomechanical performance of 3 loop-suture materials used in a locking 6-strand flexor tendon repair configuration: braided polyblend (FiberLoop 4-0), cable nylon (Supramid Extra II 4-0), and braided polyester (Tendo-Loop 4-0). We hypothesized that, using this technique, the braided polyblend suture would give superior tensile strength compared with the other 2 suture materials.
  
  
  METHODS
  We divided 30 fresh porcine flexor tendons transversely and repaired each with 1 of the 3 suture materials using a modified Lim-Tsai 6-strand suture technique. We loaded the repaired tendons to failure using a materials testing machine and collected data on the mechanism of failure, ultimate tensile strength, gap strength, and stiffness.
  
  
  RESULTS
  Failure mechanisms for the repaired specimens were as follows: the braided polyblend had 50% suture breakage and 50% suture pullout; the cable nylon had 100% suture breakage; and the braided polyester had 80% suture breakage and 20% suture pullout. Specimens repaired with the braided polyblend suture had the highest mean ultimate tensile strength (97 N; standard deviation, 22) and the highest mean gap force (35 N; standard deviation, 7).
  
  
  CONCLUSIONS
  This study supports the findings of previous studies showing superior strength of the braided polyblend suture.
  
  
  CONCLUSIONS
  We were able to achieve up to 124 N in ultimate tensile strength and 48 N of gap force with this suture in porcine tendons. This gives greater confidence in starting immediate controlled passive or active rehabilitation after repair of flexor tendon injuries.
authors.affiliation: Department of Hand Surgery, Singapore General Hospital, Singapore.
authors.forename: Aaron W T
authors.initials: AW
authors.lastname: Gan
authors.forename: Puay Yong
authors.initials: PY
authors.lastname: Neo
authors.forename: Min
authors.initials: M
authors.lastname: He
authors.forename: Andrew K T
authors.initials: AK
authors.lastname: Yam
authors.forename: Alphonsus K S
authors.initials: AK
authors.lastname: Chong
authors.forename: Shian Chao
authors.initials: SC
authors.lastname: Tay
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D006801:Humans; D011182:Postoperative Care; D013536:Suture Techniques; D013537:Sutures / Q000592:standards*; D013552:Swine; D013708:Tendon Injuries / Q000534:rehabilitation / Q000601:surgery*; D013718:Tensile Strength