Using Q Suture to Enhance Resistance to Gap Formation and Tensile Strength of Repaired Flexor Tendons

10.3791/61445 ◽  
2020 ◽  
Author(s):  
Wei Feng Mao ◽  
Ya Fang Wu
Keyword(s):  
Tensile Strength ◽  
Gap Formation ◽  
Flexor Tendons

Increased Suture Embedment in Tendons: An Effective Method to Improve Repair Strength

2002 ◽  
Vol 27 (4) ◽  
pp. 333-336 ◽  
Author(s):  
B. WANG ◽  
J. B. TANG
Keyword(s):  
Tensile Strength ◽  
Tensile Properties ◽  
Ultimate Strength ◽  
Tensile Testing ◽  
Testing Machine ◽  
Gap Formation ◽  
Tensile Testing Machine ◽  
Flexor Tendons ◽  
Important Contributor ◽  
Complete Failure

We evaluated the effect of length of suture embedment within tendons on the tensile strength of repaired tendons. Thirty fresh pig flexor tendons were divided into three groups and subjected to repairs with the Halsted tendon sutures in which 1/3, 1/2, and 2/3 of the length of the longitudinal sutures was embedded within the tendons. The repaired tendons were pulled to complete failure by an Instron tensile testing machine. The 2 mm gap-formation force, ultimate strength, stiffness, and energy to failure were greatest when 2/3 of the suture length was embedded within the tendon. The results indicate that suture embedment is an important contributor to the tensile properties of the repair, and that increase in length of suture embedment is an effective way to strengthen tendon repairs.

Changes in Tendon Strength After Partial Cut and Effects of Running Peripheral Sutures

2003 ◽  
Vol 28 (5) ◽  
pp. 478-482 ◽  
Author(s):  
J. TAN ◽  
B. WANG ◽  
B. TAN ◽  
Y. XU ◽  
J. B. TANG
Keyword(s):  
Tensile Strength ◽  
Tensile Properties ◽  
Ultimate Strength ◽  
The Other ◽  
Flexor Digitorum Profundus ◽  
Gap Formation ◽  
Load To Failure ◽  
Flexor Digitorum ◽  
Lower Tensile Strength

We performed a study to evaluate the tensile properties of partial tendon lacerations and the effects of peripheral sutures on the tendon strength. Seventy-two fresh pig flexor digitorum profundus tendons were divided equally into eight groups. Tendons in four of the groups were subjected to partial lacerations (60%, 70%, 80%, and 90%) and were not repaired. In the other four similar groups partial lacerations were repaired with running peripheral sutures. The tendons were subjected to load-to-failure tests in an Instron tensile machine to determine the initial, 1 mm, 2 mm gap formation forces and the ultimate strength. The tendons with lacerations of 80% and 90% had a remarkably lower tensile strength than those 60% and 70% lacerations. Running peripheral sutures increased the gap formation forces and the ultimate strength of all the tendons, though particularly those with 80% and 90% lacerations.

Primary Repair Of Flexor Tendons In The Hand Without Immobilisation – Preliminary Report

HAND ◽  
1978 ◽  
Vol os-10 (1) ◽  
pp. 37-47 ◽  
Author(s):  
Hilton Becker
Keyword(s):  
Blood Supply ◽  
Preliminary Report ◽  
Suture Material ◽  
Flexor Tendon ◽  
Primary Repair ◽  
Tendon Repair ◽  
Gap Formation ◽  
Flexor Tendon Repair ◽  
New Approach ◽  
Flexor Tendons

summary A new approach to the problem of flexor tendon repair within the fibro-osseous canal is presented. Using a technique of bevelling the tendon ends and suturing with a fine suture material, under magnification, a sufficiently strong junction is obtained, which enables immediate active mobilisation without strangulation of the blood supply. The junction can resist gap formation up to tensions of 4 Kg. It is postulated that under these conditions tendon nutrition is minimally interfered with, adhesions do not form, and the tendon heals by its own intrinsic healing ability.

Helical 6-Strand Cruciate Tenorrhaphy: Description of a New Technique and Biomechanical Comparative Analysis With 2 Standard Techniques

Hand ◽  
2020 ◽  
pp. 155894471989713 ◽  
Author(s):  
Carlos Eduardo Torres Fuentes ◽  
Francisco Sebastián Carvajal Flechas ◽  
Julián Andrés Hernández ◽  
Juan Sebastián Abaunza Ubaque ◽  
Dayana Beatriz Carmona García ◽  
...  
Keyword(s):  
Tensile Strength ◽  
Ultimate Tensile Strength ◽  
Ex Vivo ◽  
Tendon Repair ◽  
Early Mobilization ◽  
Standard Technique ◽  
Biomechanical Study ◽  
Flexor Tendons ◽  
Significant Difference ◽  
Standard Techniques

Background: Multiple flexor tendon repair techniques have been developed over the last years. Despite all this, there is no standard technique that has proven to be superior to others, leading to great variability in the use of techniques in surgical practice. We describe a novel tendon repair technique and compare its biomechanical characteristics with 2 conventional techniques. Methods: Comparative experimental biomechanical study in ex vivo animal models. In all, 66 deep flexor tendons of the pig’s front legs were taken and it’s repair was performed by 1 of 3 techniques (helical 6-strand cruciate tendon repair, Adelaide tendon repair, or modified Kessler). These repairs were subjected to biomechanical study, measuring, and registering the ultimate tensile strength, load to 2-mm gap force, and stiffness. Results: The helical 6-strand cruciate tenorrhaphy compared with the Adelaide and modified Kessler techniques carries statistically significant greater ultimate tensile strength before failure (65.5, 46, and 36 N, respectively, P < .001). It also required a greater load to 2-mm gap force and is less stiff, allowing greater strain before failure. This technique does not generate significant changes in the dimensions of the tendons compared to the others, and there was no significant difference in the strength of repair between surgeons. Conclusions: The helical 6-strand cruciate tenorrhaphy is a novel technique, useful for the repair of flexor tendons in the hand that holds up the necessary forces to initiate early mobilization in the postoperative period and has better biomechanical properties than 2 standard techniques.

Early Breaking Strength of Repaired Flexor Tendon Treated with 5-Fluorouracil

2001 ◽  
Vol 26 (3) ◽  
pp. 220-223 ◽  
Author(s):  
S. CEROVAC ◽  
A. AFOKE ◽  
A. AKALI ◽  
D. A. McGROUTHER
Keyword(s):  
Tensile Strength ◽  
Normal Saline ◽  
Tensile Testing ◽  
Matched Control ◽  
Flexor Tendon ◽  
Breaking Strength ◽  
Adhesion Formation ◽  
Flexor Tendons ◽  
And Control

This study investigated the effect of a single intraoperative application of 5-fluorouracil, which may diminish peritendinous adhesion formation, on the tensile strength of repaired digital flexor tendons after 7, 14 and 21 days of healing. Twenty-seven deep flexor tendons from 14 rabbits were exposed to 5-fluorouracil (50 mg/ml) for 5 minutes immediately after repair whereas matched control tendons were exposed to normal saline. Tensile testing at 7, 14 and 21 days revealed no significant differences in the gap or ultimate strengths of the 5-fluorouracil treated and control tendons.

Barbed versus smooth poly- propylene three-loop pulley sutures for repair of canine gastrocnemius tendon

2014 ◽  
Vol 27 (06) ◽  
pp. 436-440 ◽  
Author(s):  
T. A. Harper ◽  
M. A. Mitchell ◽  
M. S. McFadden ◽  
B. Heggem Perry ◽  
B. S. Perry
Keyword(s):  
Tensile Strength ◽  
Testing Machine ◽  
Tendon Repair ◽  
Barbed Suture ◽  
Materials Testing ◽  
Gap Formation ◽  
Failure Loads ◽  
Poly Propylene ◽  
Polypropylene Sutures

SummaryObjective: To compare the ultimate tensile strength (UTS) and load to 1 and 3 mm gap formation of smooth (3-metric) and knotless barbed (4-metric) polypropylene sutures placed in a three-loop pulley pattern for canine gastrocnemius tendon repair.Study design: In vitro.Sample size: Thirty-three paired bonetendon units with one of each pair assigned to each suture type. Barbed suture size was based on previously published materials testing results.Methods: Each unit was placed in a servohydraulic testing machine and tested under single cycle tensile loading until repair failure.Results: There was a significantly higher UTS for smooth polypropylene compared to the barbed polypropylene repairs. The loads resulting in 1 and 3 mm gaps for the barbed repairs were consistently significantly less than the corresponding smooth polypropylene repair values.Conclusion: The knotted smooth polypropylene repair was consistently stronger than the knotless barbed polypropylene repair when placed in a three-loop pulley pattern for gastrocnemius repair.Clinical significance: Knotless barbed polypropylene suture should not be considered equivalent to knotted smooth polypropylene of comparable tensile strength when placed in a three-loop pulley pattern for canine gastrocnemius tendon repair. The low failure loads of the barbed repair are probably due to failure of the barbs to anchor consistently throughout the tendon in the knotless configuration.

Effect of Suture Knots on Tensile Strength of Repaired Canine Flexor Tendons

1995 ◽  
Vol 20 (1) ◽  
pp. 72-75 ◽  
Author(s):  
M. AOKI ◽  
D. L. PRUITT ◽  
H. KUBOTA ◽  
P. R. MANSKE
Keyword(s):  
Tensile Strength ◽  
Ultimate Tensile Strength ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Repair Site ◽  
Flexor Tendons ◽  
The One ◽  
Flexor Digitorum

59 dog cadaver flexor digitorum profundus tendons were repaired with one or two knots inside or outside the tendon, using two, four and six suture strands. The ultimate tensile strength and gap strengths were compared. Locating the knots outside rather than within the tendon repair site showed significantly higher ultimate tensile strength for two, four, and six strand sutures. The strength was greater in one knot than in two knot sutures; the value of the six-strand suture using the one knot outside technique was the greatest. Similarly, increased gap strength was also obtained from the one-knot-outside technique. We concluded that the knots should be located away from the tendon repair site and there should be as few as possible.

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