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Biomechanical Comparison of a New Loop Suture Technique With Conventional Techniques of Flexor Tendon Repair

An In Vitro Study

Yildiran, Gokce, MD; Akdag, Osman, MD; Tosun, Zekeriya, MD

doi: 10.1097/SAP.0000000000001625

Introduction Flexor tendon repair techniques that can resist active forces are widely accepted. Despite that many suture techniques have been described, the “perfect repair” for flexor tendons cannot be achieved yet. We aimed to compare a new loop suture technique with commonly used flexor tendon repair methods biomechanically in hen tendon.

Method We used 25 hen flexor tendons for each group (4-strand modified Kessler, grasping cruciate, Tsuge, and new technique groups). After the tendons were divided into 2, they were repaired according to these 4 techniques, were subjected to the initial stretching of 0.5 N, and pulled in the opposite directions. When a gap of 2 mm occurred, the test was terminated and the forces at that time were recorded. These strain forces were compared and evaluated statistically.

Results New technique had the best tensile strength results statistically. Modified Kessler and grasping cruciate took the second place and Tsuge repair gave the worst strain forces results.

Conclusions With loop suture, 4 strands can be obtained with only 2 passes of the needle, and we think that much more tensile strength can be achieved because of the vertical transition and locking configurations of the new loop suture technique.

From the Plastic, Reconstructive and Aesthetic Surgery Department, Hand Surgery Division, Selcuk University Medical Faculty, Konya, Turkey.

Received June 5, 2018, and accepted for publication, after revision July 21, 2018.

Conflicts of interest and sources of funding: none declared.

Reprints:Gokce Yildiran, MD, Selcuk University Medical Faculty Alaaddin Keykubat Campus, Plastic, Reconstructive and Aesthetic Surgery Department, Hand Surgery Division, Selcuklu, Konya, Turkey. E-mail:

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