Background: This study evaluated the biomechanical performance of a novel asymmetric 6-strand flexor tendon repair technique without locking loops. Methods: Twenty porcine flexor tendons were equally repaired by using the asymmetric technique and compared with the modified Lim-Tsai repair technique. The ultimate tensile strength, load to 1-mm gap force, stiffness, and mechanism of failure were measured. Results: The asymmetric repair technique had significantly higher tensile strength (63.3 ± 3.7 N) than the modified Lim-Tsai repairs (46.7 ± 8.3 N). Conclusions: A novel flexor tendon repair technique with improved biomechanical performance may be available for use in flexor tendon repairs.
AngelesJGHemingerHMassDP.Comparative biomechanical performances of 4-strand core suture repairs for zone II flexor tendon lacerations. J Hand Surg Am. 2002;27(3):508-517.
2.
BainbridgeLCRobertsonCGilliesDet al. A comparison of post-operative mobilization of flexor tendon repairs with “passive flexion-active extension” and “controlled active motion” techniques. J Hand Surg Br. 1994;19:517-521.
3.
BarrieKAWolfeSWSheanCet al. A biomechanical comparison of multistrand flexor tendon repairs using an in situ testing model. J Hand Surg Am. 2000;25:499-506.
4.
CaoYTangJB.Biomechanical evaluation of a four-strand modification of the Tang method of tendon repair. J Hand Surg Br. 2005;30:374-378.
5.
CroogAGoldsteinRNasserPet al. Comparative biomechanic performances of locked cruciate four-strand flexor tendon repairs in an ex vivo porcine model. J Hand Surg Am. 2007;32:225-232.
6.
DinopoulosHTBoyerMIBurnsMEet al. The resistance of a four- and eight-strand suture technique to gap formation during tensile testing: an experimental study of repaired canine flexor tendons after 10 days of in vivo healing. J Hand Surg Am. 2000;25:489-498.
7.
DogramaciYKalaciASevinçTTet al. Purchase points affect the biomechanical behavior of a tendon repair? A biomechanical evaluation using different Kessler methods of flexor tendon repair. Hand. 2008;3:266-270.
8.
EdsfeldtSRempelDKursaKet al. In vivo flexor tendon forces generated during different rehabilitation exercises. J Hand Surg Eur Vol. 2015;40:705-710.
9.
GanAWNeoPYHeMet al. A biomechanical comparison of 3 loop suture materials in a 6-strand flexor tendon repair technique. J Hand Surg Am. 2012;37:1830-1834.
10.
GillRSLimBHShatfordRAet al. A comparative analysis of the six-strand double-loop flexor tendon repair and three other techniques: a human cadaveric study. J Hand Surg Am. 1999;24:1315-1322.
11.
GriffinMHindochaSJordanDet al. An overview of the management of flexor tendon injuries. Open Orthop J. 2012;6:28-35.
12.
HavulinnaJLeppanenOVJärvinenTLet al. Comparison of modified Kessler tendon suture at different levels in the human flexor digitorum profundus tendon and porcine flexors and porcine extensors: an experimental biomechanical study. J Hand Surg Eur Vol. 2011;36:670-676.
13.
KesslerINissimF.Primary repair without immobilization of flexor tendon division within the digital sheath. An experimental and clinical study. Acta Orthop Scand. 1969;40:587-601.
14.
KubotaHManskePRAokiMet al. Effect of motion and tension on injured flexor tendons in chickens. J Hand Surg Am. 1996;21:456-463.
15.
RudgeWBJJamesM.Flexor tendon injuries in the hand: a UK survey of repair techniques and suture materials—are we following the evidence?ISRN Plastic Surg. 2014;2014:687128.
16.
SavageR.In vitro studies of a new method of flexor tendon repair. J Hand Surg Br. 1985;10:135-141.
17.
StricklandJW.Development of flexor tendon surgery: twenty-five years of progress. J Hand Surg Am. 2000;25(2):214-235.
18.
StricklandJW.Flexor tendon injuries: I. Foundations of treatment. J Am Acad Orthop Surg. 1995;3:44-62.
19.
TsugeKIkutaYMatsuishiY.Intra-tendinous tendon suture in the hand—a new technique. Hand. 1975;7:250-255.
20.
WongYRLeeCSLokeAMet al. Comparison of flexor tendon repair between 6-strand Lim-Tsai with 4-strand Cruciate and Becker technique. J Hand Surg Am. 2015;40(9):1806-1811.
21.
XieRGZhangSTangJBet al. Biomechanical studies of 3 different 6-strand flexor tendon repair techniques. J Hand Surg Am. 2002;27:621-627.
