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A Clove-Hitch Suture Method for Small-Caliber Tendon Ends

Abraham, Edward MD; League, Alan MD; Amirouche, Farid PhD; Kulkarni, Nikhil MS Eng

Journal of Bone & Joint Surgery - American Volume: 18 July 2012 - Volume 94 - Issue 14 - p 1303–1307
doi: 10.2106/JBJS.K.00414
Scientific Articles

Background: The choices of suture methods used to secure the end of a small-caliber tendon with a combination of suture materials passing through and looping around the tendon are not well documented. A secure stitch-tendon unit may be an important factor in preserving muscle function, by facilitating healing without gapping or failure.

Methods: Five types of suture methods utilizing four or fewer passes through the tendon end were mechanically tested on 178 canine flexor digitorum profundus tendons. An Instron apparatus was used to test the load to failure.

Results: The single and double clove-hitch suture methods demonstrated improved repair strength when compared with the three other methods studied in this small-caliber canine tendon model.

Conclusions: The single and double clove-hitch suture method better secured the end of a small-caliber tendon compared with other methods.

Clinical Relevance: The single (pull-out) and double (non-pull-out) clove-hitch suture methods are reliable alternatives for the repair of small-caliber tendons.

1Department of Orthopaedics, University osf Illinois College of Medicine, 835 South Wolcott Avenue, E270, Chicago, IL 60612. E-mail address for E. Abraham: E-mail address for A. League:

2Department of Mechanical and Industrial Engineering, University of Illinois at Chicago, 2039 Engineering Research Facility, 842 West Taylor Street, Chicago, IL 60607. E-mail address for F. Amirouche: E-mail address for N. Kulkarni:

Copyright 2012 by The Journal of Bone and Joint Surgery, Incorporated
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