Enhanced Zone II Flexor Tendon Repair through a New Half Hitch Loop Suture Configuration.
This study evaluated the impact of a new half hitch loop suture configuration on flexor tendon repair mechanics. Cadaver canine flexor digitorum profundus tendons were repaired with 4- or 8-strands, 4-0 or 3-0 suture, with and without half hitch loops. An additional group underwent repair with half hitch loops but without the terminal knot. Half hitch loops improved the strength of 8-strand repairs by 21% when 4-0, and 33% when 3-0 suture was used, and caused a shift in failure mode from suture pullout to suture breakage. 8-strand repairs with half hitch loops but without a terminal knot produced equivalent mechanical properties to those without half hitch loops but with a terminal knot. 4-strand repairs were limited by the strength of the suture in all groups and, as a result, the presence of half hitch loops did not alter the mechanical properties. Overall, half hitch loops improved repair mechanics, allowing failure strength to reach the full capability of suture strength. Improving the mechanical properties of flexor tendon repair with half hitch loops has the potential to reduce the postoperative risk of gap formation and catastrophic rupture in the early postoperative period.
Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri, United States of America.
Ioannis
I
Kormpakis
Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri, United States of America.|Department of Biomedical Engineering, Washington University, St. Louis, Missouri, United States of America.
Stephen W
http://orcid.org/0000-0002-1797-5870
SW
Linderman
Department of Orthopedic Surgery, Columbia University, New York, New York, United States of America.|Department of Biomedical Engineering, Columbia University, New York, New York, United States of America.
Stavros
S
Thomopoulos
Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri, United States of America.
Richard H
RH
Gelberman
D000818:Animals; D001696:Biomechanical Phenomena; D002102:Cadaver; D004285:Dogs; D005260:Female; D012421:Rupture / Q000517:prevention & control*; D013536:Suture Techniques / Q000295:instrumentation*; D013708:Tendon Injuries / Q000601:surgery*; D013718:Tensile Strength