Our goal was to investigate and compare the mechanical properties of multifilament stainless steel suture (MFSS) and polyethylene multi-filament core FiberWire in flexor tendon repairs. Flexor digitorum profundus tendons were repaired in human cadaver hands with either a 4-strand cruciate cross-lock repair or 6-strand modified Savage repair using 4-0 and 3-0 multifilament stainless steel or FiberWire. The multifilament stainless steel repairs were as strong as those performed with FiberWire in terms of ultimate load and load at 2 mm gap. This study suggests that MFSS provides as strong a repair as FiberWire. The mode of failure of the MFSS occurred by the suture pulling through the tendon, which suggests an advantage in terms of suture strength.
AmadioPC. Friction of the gliding surface. Implications for tendon surgery and rehabilitation. J Hand Ther. 2005, 18: 112–9.
2.
BarrieKAWolfeSWSheanCShenbagamurthiDSladeJF3rdPanjabiMM. A biomechanical comparison of multistrand flexor tendon repairs using an in situ testing model. J Hand Surg Am. 2000, 25: 499–506.
3.
BarrieKATomakSLCholewickiJMerrellGAWolfeSW. Effect of suture locking and suture caliber on fatigue strength of flexor tendon repairs. J Hand Surg Am. 2001, 26: 340–6.
4.
BhatiaDTannerKEBonfieldWCitronND. Factors affecting the strength of flexor tendon repair. J Hand Surg Br. 1992, 17: 550–2.
5.
BunnellS. Treatment of injuries of the hand. California and western medicine. 1929, 30: 1–5.
6.
BunnellS. Primary repair of severed tendons the use of stainless steel wire. Am J Surg. 1940, 47: 502–16.
7.
DonaEGianoutsosMPWalshWR. Optimizing biomechanical performance of the 4-strand cruciate flexor tendon repair. J Hand Surg Am. 2004, 29: 571–80.
8.
GelbermanRHBoyerMIBrodtMDWintersSCSilvaMJ. The effect of gap formation at the repair site on the strength and excursion of intrasynovial flexor tendons. An experimental study on the early stages of tendon-healing in dogs. J Bone Joint Surg Am. 1999, 81: 975–82.
9.
GillRSLimBHShatfordRATothEVoorMJTsaiTM. 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: 1315–22.
10.
GreenwaldDShumwaySAlbearPGottliebL. Mechanical comparison of 10 suture materials before and after in vivo incubation. J Surg Res. 1994, 56: 372–7.
11.
HatanakaHKojimaTMizoguchiTUeshinY. Aggressive active mobilization following zone II flexor tendon repair using a two-strand heavy-gauge locking loop technique. J Orthop Sci. 2002, 7: 457–61.
12.
HoffmannGLBuchlerUVogelinE. Clinical results of flexor tendon repair in zone II using a six-strand double-loop technique compared with a two-strand technique. J Hand Surg Eur. 2008, 33: 418–23.
13.
IlahiOAYounasSAHoDMNoblePC. Security of knots tied with ethibond, fiberwire, orthocord, or ultrabraid. Am J Sports Med. 2008, 36: 2407–14.
14.
KomatsuFMoriRUchioY. Optimum surgical suture material and methods to obtain high tensile strength at knots: problems of conventional knots and the reinforcement effect of adhesive agent. J Orthop Sci. 2006, 11: 70–4.
15.
LawrenceTMDavisTR. A biomechanical analysis of suture materials and their influence on a four-strand flexor tendon repair. J Hand Surg Am. 2005, 30: 836–41.
16.
LindsayWKThomsonHGWalkerFG. Digital flexor tendons: an experimental study. Part II. The significance of a gap occurring at the line of suture. Br J Plast Surg. 1960, 3: 1–9.
17.
McDonaldEGordonJABuckleyJMGordonL. Comparison of a new multifilament stainless steel suture with frequently used sutures for flexor tendon repair. J Hand Surg Am. 2011, 36: 1028–34.
18.
MillerBDoddsSDdeMarsAZagoreasNWaitayawinyuTTrumbleTE. Flexor tendon repairs: the impact of fiberwire on grasping and locking core sutures. J Hand Surg Am. 2007, 32: 591–6.
19.
SavageR. In vitro studies of a new method of flexor tendon repair. J Hand Surg Br. 1985, 10: 135–41.
20.
SavageRRisitanoG. Flexor tendon repair using a “six strand” method of repair and early active mobilisation. J Hand Surg Br. 1989, 14: 396–9.
21.
SchuindFGarcia-EliasMCooneyWP3rdKNAn. Flexor tendon forces: in vivo measurements. J Hand Surg Am. 1992, 17: 291–8.
22.
TarasJSRaphaelJSMarczykSCBauerleWB. Evaluation of suture caliber in flexor tendon repair. J Hand Surg Am. 2001, 26: 1100–4.
23.
ThurmanRTTrumbleTEHanelDPTencerAFKiserPK. Two-, four-, and six-strand zone II flexor tendon repairs: an in situ biomechanical comparison using a cadaver model. J Hand Surg Am. 1998, 23: 261–5.
24.
TrailIAPowellESNobleJ. An evaluation of suture materials used in tendon surgery. J Hand Surg Br. 1989, 14: 422–7.
25.
WaitayawinyuTMartineauPALuriaSHanelDPTrumbleTE. Comparative biomechanic study of flexor tendon repair using FiberWire. J Hand Surg Am. 2008, 33: 701–8.
