title: The effect of barbed suture tendon repair on work of flexion.
abstract: OBJECTIVE
  To compare the work of flexion, ultimate strength, and gap resistance of a conventional 4-strand tendon repair to a knotless barbed-suture 4-strand tendon repair.
  
  
  METHODS
  Tendon repairs were performed on 16 cadaver flexor digitorum profundus tendons using either a 4-strand double Kessler repair or a similar but knotless 4-strand repair with a unidirectional barbed suture. Work of flexion, gap resistance during cyclical loading, and ultimate strength of both techniques were determined and their means compared.
  
  
  RESULTS
  There was no difference in mean maximum load and gap formation between the 2 techniques. Work of flexion was higher for the barbed-suture repair group compared with the traditional repair group (39 N·mm vs 31 N·mm).
  
  
  CONCLUSIONS
  The higher work of flexion in the barbed-suture group suggests that barbed suture may negatively affect tendon gliding within the flexor tendon sheath.
  
  
  CONCLUSIONS
  Knotless barbed-suture tendon repair leads to increased work of flexion compared with traditional flexor tendon repairs, which may result in an increased rupture incidence.
authors.affiliation: Department of Plastic Surgery, University of Texas Southwestern Medical Center at Dallas, Dallas, TX.
authors.forename: Oded
authors.initials: O
authors.lastname: Ben-Amotz
authors.affiliation: Department of Plastic Surgery, University of Texas Southwestern Medical Center at Dallas, Dallas, TX.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kargel
authors.affiliation: Department of Plastic Surgery, University of Texas Southwestern Medical Center at Dallas, Dallas, TX.
authors.forename: Brian
authors.initials: B
authors.lastname: Mailey
authors.affiliation: Department of Plastic Surgery, University of Texas Southwestern Medical Center at Dallas, Dallas, TX. Electronic address: douglas.sammer@utsouthwestern.edu.
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Sammer
mesh_terms: D001696:Biomechanical Phenomena; D002102:Cadaver; D006801:Humans; D019651:Plastic Surgery Procedures / Q000379:methods*; D013536:Suture Techniques; D013537:Sutures; D013708:Tendon Injuries / Q000601:surgery*; D013710:Tendons / Q000601:surgery*; D013718:Tensile Strength
keywords: Barbed suture; flexor tendon; repair strength; work of flexion