Evaluation of a New 4-Strand Flexor Tendon Repair in a Cadaveric Porcine Model

Journal of Hand Surgery

Volumn 34, Issue 1, 2009, Pages 102-107

  Manchio, Jeffrey V ^a   Shashikant, Mark P ^a   Shrivastava, Anshuman ^a   Weinzweig, Jeffrey ^a   Vernadakis, Adam J ^a  

^a LAHEY HOSPITAL AND MEDICAL CENTER   (United States)

Author keywords

biomechanics; Flexor tendon repair; gap formation; porcine model; suture technique; tensile properties

Indexed keywords

ANIMAL TISSUE; ARTICLE; BIOMECHANICS; CONTROLLED STUDY; EXPERIMENTAL MODEL; FLEXOR DIGITORUM PROFUNDUS; FLEXOR MUSCLE; FLEXOR TENDON; FORELIMB; HAND MUSCLE; INTERMETHOD COMPARISON; KESSLER TECHNIQUE; LAHEY TECHNIQUE; MALE; NONHUMAN; OPERATION DURATION; PRIORITY JOURNAL; SUTURING METHOD; SWINE; TENDON RECONSTRUCTION; TENSILE STRENGTH;

EID: 58149087369     PISSN: 03635023     EISSN: 15316564     Source Type: Journal    
DOI: 10.1016/j.jhsa.2008.09.007     Document Type: Article

References (38)

1. McLarney E., Hoffman H., and Wolfe S.W. Biomechanical analysis of the cruciate four-strand flexor tendon repair. J Hand Surg 24A (1999) 295-301
2. Savage R. In vitro studies of a new method of flexor tendon repair. J Hand Surg 10B (1985) 135-141
3. Lawrence T.M., Woodruff M.J., Aladin A., and Davis T.R. An assessment of the tensile properties and technical difficulties of two- and four-strand flexor tendon repairs. J Hand Surg 30B (2005) 294-297
4. Kubota H., Aoki M., Pruitt D.L., and Manske P.R. Mechanical properties of various circumferential tendon suture techniques. J Hand Surg 21B (1996) 474-480
5. Winters S.C., Gelberman R.H., Woo S.L., Chan S.S., Grewal R., and Seiler J.G. The effects of multiple-strand suture methods on the strength and excursion of repaired intrasynovial flexor tendons: a biomechanical study. J Hand Surg 23A (1998) 97-104
6. Barrie K.A., Wolfe S.W., Shean C., Shenbagamurthi D., Slade J.F., and Panjabi M.M. A biomechanical comparison of multistrand flexor tendon repairs using an in situ model. J Hand Surg 25A (2000) 499-506
7. Pennington D.G. The locking loop tendon suture. Plast Reconstr Surg 63 (1979) 648-652
8. Hotokezaka S., and Manske P.R. Differences between locking loops and grasping loops: effects on 2-strand core suture. J Hand Surg 22A (1997) 995-1003
9. Wagner W.F., Carroll C., Strickland J.W., Heck D.A., and Toombs J.P. A biomechanical comparison of techniques of flexor tendon repair. J Hand Surg 19A (1994) 979-983
10. Strickland J.W. Flexor tendon injuries: I. Foundations of treatment. J Am Acad Orthop Surg 3 (1995) 44-54
11. Strickland J.W. Development of flexor tendon surgery: twenty-five years of progress. J Hand Surg 25A (2000) 214-235
12. Strick M.J., Filan S.L., Hile M., McKenzie C., Walsh W.R., and Tonkin M.A. Adhesion formation after flexor tendon repair: a histologic and biomechanical comparison of 2- and 4-strand repairs in a chicken model. J Hand Surg 29A (2004) 15-21
13. Gelberman R.H., Amifl D., Gonsalves M., Woo S., and Akeson W.H. The influence of protected passive mobilization on the healing of flexor tendons: a biomechanical and microangiographic study. Hand 13 (1981) 120-128
14. Messina A. The double armed suture: tendon repair with immediate mobilization of the fingers. J Hand Surg 17A (1992) 137-142
15. Lee H. Double loop locking suture: a technique of tendon repair for early active mobilization. Part II: clinical experience. J Hand Surg 15A (1990) 953-958
16. Elliot D., Moiemen N.S., Flemming A.F.S., Harris S.B., and Foster A.J. The rupture rate of acute flexor tendon repairs mobilized by the controlled active motion regimen. J Hand Surg 19B (1994) 607-612
17. Peck F.H., Bucher C.A., Watson J.S., and Roe A. A comparative study of two methods of controlled mobilization of flexor tendon repairs in zone 2. J Hand Surg 23B (1998) 41-45
18. Peck F.H., Kennedy S.M., Watson J.S., and Roe A. An evaluation of the influence of practitioner-led hand clinics on rupture rates following primary tendon repair in the hand. Br J Plast Surg 57 (2004) 45-49
19. Small J.O., Brennen M.D., and Colville J. Early active mobilization following flexor tendon repair in zone 2. J Hand Surg 14B (1989) 383-390
20. Yuen M.H., and Ip W.Y. Tensile strength of modified 4-strand cruciate technique for transversely or obliquely lacerated tendons. J Ortho Surg 15 (2007) 27-31
21. Smith A.M., and Evans D.M. Biomechanical assessment of a new type of flexor tendon repairs. J Hand Surg 26B (2001) 217-219
22. Cao Y., Zhu B., Xie R.G., and Tang J.B. Influence of core suture purchase length on strength of four-strand tendon repairs. J Hand Surg 31A (2006) 107-112
23. Tang J.B., Zhang Y., Cao Y., and Xie R.G. Core suture purchase affects strength of tendon repairs. J Hand Surg 30A (2005) 1262-1266
24. Hirpara K.M., Sullivan P.J., and O'Sullivan M.E. The effects of freezing on the tensile properties of repaired porcine flexor tendon. J Hand Surg 33A (2008) 353-358
25. Seradge H. Elongation of the repair configuration following flexor tendon repair. J Hand Surg 8 (1983) 182-185
26. Hatanaka H., and Manske P.R. Effect of the cross-sectional area of locking loops in flexor tendon repair. J Hand Surg 24A (1999) 751-760
27. Diao E., Hariharan J.S., Soejima O., and Lotz J.C. Effect of peripheral suture depth on strength of tendon repairs. J Hand Surg 21A (1996) 234-239
28. Xie R.G., Xue H.G., Gu J.H., Tan J., and Tang J.B. Effects of locking area on strength of 2- and 4-strand locking tendon repairs. J Hand Surg 30A (2005) 455-460
29. Aoki M., Pruitt D.L., Kubota H., and Manske P.R. Effect of suture knots on tensile strength of repaired canine flexor tendons. J Hand Surg 20B (1995) 72-75
30. Pruitt D.L., Aoki M., and Manske P.R. Effect of suture knot location on tensile strength after flexor tendon repair. J Hand Surg 21A (1996) 969-973
31. Lundborg G. Experimental flexor tendon healing without adhesion formation-a new concept of tendon nutrition and intrinsic healing mechanisms: a preliminary report. Hand 8 (1976) 235-238
32. Lundborg G., and Rank F. Experimental studies on cellular mechanisms involved in healing of animal and human flexor tendon in synovial environment. Hand 12 (1980) 3-11
33. Manske P.R., Lesker P.A., Gelberman R.H., and Rucinsky T.E. Intrinsic restoration of the flexor tendon surface in the nonhuman primate. J Hand Surg 10A (1985) 632-637
34. Gelberman R.H., Khabie V., and Cahill C.J. The revascularization of healing flexor tendons in the digital sheath: a vascular injection study in dogs. J Bone Joint Surg 73A (1991) 868-881
35. Mirsha V., Kuiper J.H., and Kelly C.P. Influence of core suture material and peripheral repair technique on the strength of Kessler flexor tendon repair. J Hand Surg 28B (2003) 357-362
36. Wang B., and Tang J.B. Embedded cross-stitch suture: an alternative to current cross-stitch peripheral suture. J Hand Surg 28B (2003) 471-474
37. Wag B., Xie R.G., and Tang B. Biomechanical analysis of a modification of Tang method of tendon repair. J Hand Surg 28B (2003) 347-350
38. Tang J.B. Indications, methods, postoperative motion and outcome evaluation of primary flexor tendon repairs in zone 2. J Hand Surg 32B (2007) 118-129