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Flexor tendon repair suture material

The following barbed suture materials have been used in experimental flexor tendon repair: Troccia et al. published their research data in 2009, where they used a 2-0 barbed bidirectional non-absorbable polypropylene suture (Quill™) for flexor tendon repair FiberWire's superior strength and reliability makes FiberWire an ideal choice when performing a Suture Flexor/Extensor Repair. FiberWire is constructed of a multi-stranded, long chain, ultra-high molecular weight polyethylene (UHMWPE) core with a braided jacket of polyester and UHMWPE Zone II flexor digitorum profundus tendon lacerations were created and then repaired using the techniques described by Kessler, Tajima, and Savage. Quantitative cross-sectional area and volumetric measurements of suture material within each repair site were determined using a digital image analysis system Immediately after a tendon repair, the tendon contributes nothing to the strength of repair. During that time, the suture itself and suture technique are the sole contributors to the strength of repair. Although stainless steel is the strongest material that can be used at the time of repair, it has serious disadvantages

The ideal suture material for flexor tendon repair needs to be easy to use, prevent gap formation but maintain its tensile properties until repair has achieved strength PTFE is a promising material for use in the flexor tendon surgery. A primary loading strength of a flexor tendon repair of 70 N or more can be achieved, provided an interlocking suture technique is used. Handling and knot-slippage could be a challenge due to extremely low friction properties A Biomechanical Analysis of Suture Materials and Their Influence on a Four-Strand Flexor Tendon Repair. Aggressive active mobilization following zone II flexor tendon repair using a two-strand heavy-gauge locking loop technique Mechanical Strength of the Side-to-Side Versus Pulvertaft Weave Tendon Repair Tendon suturing techniques. There are a number of factors that have been shown to affect the outcomes of tendon repair. The repair strength is the most important factor as the main function of the tendon is to transmit force, hence a repair must withstand the high forces applied by early active mobilisation15.This has led to an abundance of different suturing techniques described in the. A core suture purchase of 10 mm was used on all flexor tendon repairs and cross-locks were 4 mm wide29in the Adelaide group (Fig. 1). The traditional 4-strand Adelaide repair was performed using a nonabsorbable monofilament polypropylene suture (Prolene; Ethicon, Somerville, N.J.)

Suture material for flexor tendon repair: 3-0 V-Loc versus

  1. Background: To propose a new term ('construct efficiency') for the evaluation of multi strands flexor tendon repairs using different suture materials. Methods: A total of twenty specimens from 4-0 braided polyblend sutures (FiberLoop/FiberWire; Arthrex, Naples, FL) and 4-0 nylon sutures (Supramid Extra II; S. Jackson, Inc., Alexandria, VA) were subjected to tensile testing using Pneumatic Cord.
  2. Methods: Thirty-two flexor tendons were harvested and were sharply transected in zone II. The tendons were repaired with a 4-strand core suture repair using 3-0 looped nonabsorbable nylon suture. The harvested tendons were randomly assigned and repaired with either a 1- or a 2-knot construct
  3. Clinical series of primary flexor tendon repairs worldwide, using a variety of suture materials and suture configurations, all include a small, but ever present, rupture rate. That the assumption that stronger sutures will cure the problem may be false is discussed and the role of the sheath and of the patient considered
  4. Tendon repair strength has been shown to be proportional to the number of strands of suture placed across the repair site. There are multiple different types of suture material that can be used for flexor repairs, including Ticron, nylon, Ethilon, Mersilene, Prolene, and stainless steel wire
  5. e memory alloy suture and the 4-0 Ethibond suture). The forces required to cause a 1, 2, and 3 mm gap, ultimate load to failure, and repair stiffness were compared. Twenty specimens of each suture material also were tensile tested for load to failure, tensile strength, and elongation at failure. The shape memory alloy suture had a significantly higher mean resistance force to 1, 2, and 3 mm.
  6. With the knotless 4-strand Kirchmayr-Kessler technique, the barbed suture material has the potential to be used in flexor tendon surgery, but it has no advantage over the 4-strand polydioxane suture

Abstract After flexor tendon repair there is often increased resistance to tendon gliding at the repair site, which is greater for techniques using increased suture strands or suture material. This increased friction may be measured as the work of flexion in the laboratory setting Various suture materials have been used for tendon repair. Barbed suture in particular has been demonstrated to be effective for both wound closure and tendon repair. Ten fresh-frozen flexor digitorum profundus tendons of pig were transected and repaired using the two-strand modified Kirchmayr-Kessler technique As stated earlier, an absorbable suture material would be ideal for tendon repair if it maintained its maximum tensile strength during the crucial healing stage. The aim of this paper is to evaluate all the 4/0 suture materials available for the repair of flexor tendons. Several of the newer absorbable sutures were also included

Sketch showing the suture technique

Forty fresh-frozen human anatomic flexor superficialis and profundus tendons were divided and repaired via the cruciate four-strand technique using one of two suture materials (the shape memory alloy suture and the 4-0 Ethibond suture). The forces required to cause a 1, 2, and 3 mm gap, ultimate load to failure, and repair stiffness were compared Purpose: Flexor tendon repair consists of circumferential peripheral sutures in combination with core sutures to avoid fraying and reduces the exposure of suture material on tendon surface gapping force.4 Hence in flexor tendon repair the goal should be to use a high strength, low-friction suture material and construct, like the 4 strand and 6 strand core suture repairs which can withstand forces up to 60N permitting early active mobilization to get the best possible outcomes.4,8 Nomenclatur

In literature, many different suture techniques for flexor tendon repair are published and evaluated [19, 20]. In this study, 4-strand locked cruciate (Adelaide) or 6-strand M-Tang suture techniques was applied as core sutures for a single tendon repair as shown in Fig. 1. The repairs were performed on 3 different materials: 4-0 Polypropylene. The effect of knot location, suture material, and suture size on gliding resistance between the pulley and flexor tendon was investigated in a canine model. Different suture materials [monofilament nylon (Ethilon), braided polyester suture coated with silicone (Ticron) and uncoated braided polyester suture (Mersilene)] and suture sizes (4-0, 5. Introduction . This study was designed to investigate the influence of the amount of suture material on the formation of peritendinous adhesions of intrasynovial flexor tendon repairs. Materials and Methods . In 14 rabbits, the flexor tendons of the third and the fourth digit of the right hind leg were cut and repaired using a 2- or 4-strand core suture technique The Lim-Tsai repair is a 6-core repair that uses 2 double-stranded sutures. At approximately 1 cm from the repair site, a superficial locking stitch is placed to cinch the suture down to the tendon. A core stitch is placed through to the opposite side, where a cross-lock stitch is placed. Then the suture is brought back through to the center. Suture type for tendon repair traditionally consisted of non-absorbable braided synthetic polyester material, such as ethibond suture. More recent tendon repair descriptions have employed non-absorbable monofilament material as the suture of choice. Click to see full answer

Arthrex - FiberWire® Suture Flexor/Extensor Repai

For comparing flexor tendon repair using nonabsorbable su- tures with that of absorbable sutures, we referred to a study by Cullen et al. [6] for calculating the rupture rate as a percentage Flexor tendon repair strength is proportional to the number of suture strands crossing the repair site but it is not clear if each strand needs to result from a separate pass through the tendon. We examined whether one throw of looped suture across a repair site equals two separate throws of suture.

Flexor tendon repair strength is proportional to the number of suture strands crossing the repair site but it is not clear if each strand needs to result from a separate pass through the tendon Commonly Used Flexor Tendon Core Suture Methods Method Strands Knot No. Knot Location Additional Kessler 2 2 External Bunnell 2 1 External Tajima 2 2 Internal Tsuge 2 1 Internal Loop suture Lateral trap 4 2 External Strickland 4 2 Internal Savage 6 1 Internal Lee 8 2 Internal Loop suture Winters 8 1 Internal FLEXOR TENDON REPAIR SEILER 17 Various suture materials have been used for tendon repair. Barbed suture in particular has been demonstrated to be effective for both wound closure and tendon repair. Ten fresh-frozen flexor digitorum profundus tendons of pig were transected and repaired using the two-strand modified Kirchmayr-Kessler technique. The samples were divided into two groups: 4-0 barbed absorbable polyglyconate.

Two different types of reactions are known to occur in response to sutures and devices used in flexor tendon repair: early foreign body and delayed hypersensitivity (allergic) reactions.. At the histological level, foreign body reactions to sutures occur in 100% of cases and are characterized by an inflammatory zone around the suture and the presence of multinucleated giant cells. 1 This is. Tensile strength of flexor tendon repair using barbed suture material in a dynamic ex vivo model. Zeplin PH(1), Henle M, Zahn RK, Meffert RH, Schmidt K. Author information: (1)Department of Trauma, Hand, Plastic and Reconstructive Surgery, Wuerzburg University Hospital, Oberduerrbacher Str. 6, 97080 Wuerzburg, Germany The effect of modified locking methods and suture materials on Zone II flexor tendon repair-An ex vivo study Susumu Yoneda, Hirotaka Okubo, Stephen W. Linderman, Nozomu Kusano, Matthew J. Silva , Stavros Thomopoulos, Fuminori Kanaya, Richard H. Gelberma The aim of this article is to present two new techniques for digital flexor tendon repair: a modification to the conventional Kessler technique (wrap core suture) and tendon splints (H-shaped splint)

repair of flexor tendon lacerations is recommended based repair leads to abundant suture material exposed on the exterior of the tendon which increases gliding resistance, serves as a nidus for infection, and facilitates the forma-tion of peritendinous adhesions.13,16,19-2 Since the ancient age, starting with eye needles, surgical suture and misrecognizing tendon as nerve ending with fearing consequences of suturing, development of tendon knowledge and repair technique has expanded. 1-10 Starting with the invention of Bunnel suture for flexor tendon repair and facing the failure in primary flexor tendon repair due to adhesions, 3,5,6 predominant opinion was.

Repair Techniques •Core suture •Number of strands -2, 4, 6+ •Suture caliber -3-0, 4-0, 5-0 •Suture material -nylon, prolene, braided polyethylen •Placement pattern -multiple •Al-Qattan M. Zone I flexor profundus tendon repair in children 5-10 year FDP) repair site without the use of core sutures. The hypothesis being that the reclaimed FDS tendon autograft will redistribute tensile forces away from the FDP repair site, increasing overall strength and resistance to gapping in Zone II flexor tendon injuries compared with the current clinical techniques. Methods: Two novel FDP repair methods utilizing portions of FDS have been described. Lacerated flexor tendons should be treated by primary surgical repair whenever possible. The current trend of end-to-end surgical tendon repairs is to use multistrand core sutures (four-strand repairs such as cruciate, double-Tsuge, Strickland, modified Savage, or six-strand repairs such as modified Savage, Tang)

Currently, there are limited data in the literature comparing the viscoelastic properties of suture materials commonly used for flexor tendon repair.14, 16, 17, 18 This study investigates the time-dependent viscoelastic properties (creep and stress relaxation) of suture materials commonly used for flexor tendon repair, immersed in PBS at both room and body temperature The 3LP and BT were performed as previously described. 13, 32 Briefly, the 3LP repair consisted of three suture loops passing through the body of the tendon on both sides of the repair. 21 Core purchase length for suture bites for the 3LP was 2, 3, and 4 cm from the transected ends of tendon (Figure 2A).The BT involved placing the needle/probe in the mid-substance of the tendon Tendon Repair Techniques. - Gliding and gap formation for locking and grasping tendon repairs: a biomechanical study in a human cadaver model. - 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. - Taguchi. The tensile strength of three different flexor tendon repair techniques were tested in vitro: the modified Kessler technique (a two-strand repair), two 'figure of eight' sutures (a four-strand.

Flexor tendon suture methods: a quantitative analysis of

Biomechanical Properties of a Novel Mesh Suture in a Cadaveric Flexor Tendon Repair Model. Mesh suture-based flexor tendon repairs could lead to improved healing at earlier time points. The findings could allow for earlier mobilization, decreased adhesion formation, and lower rupture rates after flexor tendon repairs.. J Hand Surg Am. 2019 Repair of both FDP and FDS tendons significantly increased work of flexion. CONCLUSIONS: Resection of 1 slip of FDS tendon significantly reduces work of flexion in zone II flexor tendon repair. Suture material had no effect on this interaction

(PDF) Suture material for flexor tendon repair: 3–0 V-Loc

Suture materials and suture techniques used in tendon repai

A Repair Strong Enough for Early Mobilization. Ex vivo biomechanical studies have shown that the strength of repair is influenced by the number of core strands, suture caliber, purchase length, and suture material. 14 However, it is perplexing to find that meta-analyses of rupture rates worldwide could not identify significant differences between two-strand and multistrand repairs in clinical. RESEARCH ARTICLE The effect of modified locking methods and suture materials on Zone II flexor tendon repair—An ex vivo study Susumu Yoneda ID 1,2*, Hirotaka Okubo2, Stephen W. Linderman ID 1, Nozomu Kusano3, Matthew J. Silva1, Stavros Thomopoulos4,5, Fuminori Kanaya2, Richard H. Gelberman1 1 Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri, United States of America Gan AW, Neo PY, He M, Yam AK, Chong AK, Tay SC. A biomechanical comparison of 3 loop suture materials in a 6-strand flexor tendon repair technique. J Hand Surg Am. 2012;37(9):1830-4. pmid:22857910 . View Article PubMed/NCBI Google Scholar 10. Karjalainen T, He M, Chong AK, Lim AY, Ryhanen J Flexor tendon repair strength depends on the suture technique and the suture material used. Configurations that incorporate locking loops prevent sutures from pulling through the tendon but. A total of 5) human cadaveric tendons were studied. Zone M flexor digitorum profundus tendon lacerations were created and then repaired using the techniques described by Kessler, Tajima, and Savage. Quantitative cross-sectional area and volumetric measurements of suture material within each repair site were determined using a digital image.

Bunnell Technique and Bidirectional Barbed Suture for Flexor Tendon Repair To the Editor: Concerning the article of Jordan et al, Biomechanical analysis of flexor tendon repair using knotted Kessler and Bunnell techniques and the knotless Bunnell technique,1 I would like to make some remarks The purpose of this study was to compare two sutures; a knotted polydioxane with a knotless barbed in a 4-strand Kirchmayr-Kessler suture technique. Human flexor digitorum tendons were separated into four groups. Group 1 - polydioxane; Group 2 - barbed suture; Group 3 and 4 - same as group 1 and 2 with an additional peripheral running suture. In each group the repaired tendons were. Introduction . Injuries to the hand are common, and poor functional outcomes can have significant long-term consequences affecting both work and social activities. Good outcomes following flexor tendon lacerations in the hand are dependent on a sound surgical repair allowing early active mobilisation. Materials and Methods . We reviewed the literature regarding the choice of suture material. The effects of five factors for flexor tendon repair were tested: core suture caliber (4‐0 or 3‐0), number of sutures crossing the repair site (four‐ or eight‐strand), core suture purchase (0.75 or 1.2 cm), peripheral suture caliber (6‐0 or 5‐0), and peripheral suture purchase (superficial or 2 mm) Haddad R, Peltz TS, Walsh WR. Biomechanical evaluation of flexor tendon repair using barbed suture material: A comparative ex vivo study. J Hand Surg Am. 2011; 36 (A):1565-1566. doi: 10.1016/j.jhsa.2011.05.040. [Google Scholar

Suppl 1: An Overview of the Management of Flexor Tendon

  1. We review the indications for repair of partial tendon ruptures as well as specific suture materials and configurations used for repair and chemical adjuncts used to prevent tendon rupture and adhesion formation. The use of MRI and ultrasound in diagnosing tendon injuries and complications after surgery are also evaluated
  2. PURPOSE: Suture technique, suture material, and the number of strands all play critical roles in achieving optimal strength of flexor tendon repairs. We evaluated the contribution to the tensile strength of flexor tendon repair using the strongest suture material, Fiberwire, and the best surgical technique (locking configuration) using 2- and 4.
  3. imize suture material on the tendon surface so as to not interfere with tendon gliding or healing. Efforts to develop such repairs have resulted in innovations in suture materials, core suture techniques, and peripheral suture techniques. The resul
  4. Historically, various suture patterns and materials have been evaluated for human and equine flexor tendon repair. Results of equine studies suggest the three-loop pulley pattern (3LP) compares favorably to other patterns and is recommended for primary tenorrhaphy. However, this pattern still experiences significant gap formation and ca
  5. Purpose: Immediate surgical repair and early mobilization are essential in preventing adhesion formation and finger stiffness. A new polyethylene-based, braided suture material, Fiberwire (Arthrex, Naples, FL), touting increased strength, presents the potential for stronger repairs and, therefore, earlier active motion after surgery with a greater safety margin
  6. Increasing tensile strength of the lacerated tendon at the suture site is an important factor for initiating an early mobilization program. 1-5 The tensile strength of the repair can be higher when using locking loops, 6 locating the knots outside the repair site rather than inside the repair site, 7 increasing the number of suture strands.
  7. PURPOSE: The time-dependent mechanical behavior of common suture materials may have a pronounced influence on the quality of flexor tendon repairs with respect to gap formation. METHODS: Sutures commonly used in plastic surgery, particularly for hand tendon repair, were tested in tension for analysis of stress relaxation and creep properties
Clinical Primary Flexor Tendon Repair and Rehabilitation

Flexor tendon repair with a polytetrafluoroethylene (PTFE

  1. Different materials used for tendon repair will have a different gliding resistance (GR) at the joint. Previous studies have compared strength of repair and gliding resistance for various braided suture materials and for 100% laceration of flexor tendons. We directly compare the GR of two monofilament sutures when used for a peripheral running.
  2. The ideal suture material for flexor tendon repair needs to be easy to use, prevent gap formation but maintain its tensile properties until repair has achieved strength . Non-absorbable synthesis sutures included monofilament nylon, monofilament polypropylene and braided polyester monofilament nylon have should good biocompatibility are used in.
  3. suture material for flexor tendon repairs. In fact, some advanced suture materials have been developed to improve the strength of flexor tendon repairs. Monofilament nylon, monofilament polypropylene, coated braided polyester, and braided polyblend sutures are used in flexor tendon repair. As compared to othe
  4. The research material was dissected deep flexor porcine tendons. Three types of stitches were used: the modified Kessler suture with an additional running suture, the cruciate four-strand suture with an addi-tional running suture and the multistrand running suture. We obtained 120 sutures, 40 for each technique. Breaking strength was assesse

total of 6 suture limbs available for the repair. Small perforations are then made in the bone with a K-wire to create a vascular bed for tendon healing (Fig 3F). All 6 sutures are passed in simple fashion through the common flexor tendon to repair and compress it to its footprint (Fig 4A). The 3 suture limbs from the posterio Flexor tendon injuries can be challenging, especially in zone II. A strong repair using at least a 4-strand core suture and an associated epitendinous suture will allow for early rehabilitation, which can minimize the risk of adhesion formation lowing primary repair of flexor tendons. Furthermore, many experimental studies were initiated, focusing on flexor tendon healing, suture techniques, suture materials and post-operative rehabilitation. The evolving interest in primary flexor tendon repair stimulated research, which raised further question Nuances of Flexor Tendon Rehabilitation. This series focuses on how a therapist might thoughtfully modify protocols based on a specific patient circumstance or zone injury. Explanations of how tendon healing occurs, definition of excursion, rationale for the ideal time to start early motion, and the role of suture strength and pulleys provide.

Flexor Tendon Repair Techniques: Core Suture Techniques

The biomechanical analysis relied on 50 flexor digitorum profundus tendons harvested from fresh cadavers. The tendons were randomly divided into five groups, transected, and repaired by use of a 1. double-loop suture, 2. double modified locking Kessler, 3. four-strand Savage, 4. modified six-strand Savage, and 5. the new technique In general, the more strands of suture material that cross the tendon repair, the stronger the repair . 7-9,20,21 Fig. 11-6 Tensile strengths of flexor tendon repairs compared with the tension developed within the tendon with use of the hand Choice of suture material is an important factor in flexor tendon repair, which is reflected in efforts to determine the best tendon suture material. Few studies have investigated the range of suture materials available to the surgeon. 2 The sheath should be closed using a fine suture material after completion of repair of severed flexor tendon. In case of severe damage to the sheath, it may be necessary to excise the portion of the sheath over the repaired tendon site to prevent trigger finger or an impingement

Suture techniques for tendon repair; a comparative revie

materials are easier, yet strong enough for controlled rehabilitation. Lawrence T and Davis T: A biomechanical analysis of suture materials and their influence on a 4‐strand flexor tendon repair. J Hand Surg [Am] 30:836‐841, 2005. Strickland JW: Development of flexor tendon surgery: Twenty‐five years of progress The management of flexor tendon injuries has evolved in recent years through industrial improvements in suture materials, re-finements of repair methods, and early rehabilitation protocols [1-6]. However, there is no consensus on the ideal suture mate-Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanica Research Article Four-Strand Core Suture Improves Flexor Tendon Repair Compared to Two-Strand Technique in a Rabbit Model AliceWichelhaus, 1 SaschaTobiasBeyersdoerfer, 1 BrigitteVollmar, 2 ThomasMittlmeier, 1 andPhilipGierer 1 Abteilung f ur Unfall-, Hand- und Wiederherstellungschirurgie, Chirurgische Universit ¨atsklinik Rostock Nowadays, a barbed suture material offers the possibility of knotless flexor tendon repair but many hospitals use non-barbed suture materials. The purpose of this study was to compare a barbed suture material and a non-barbed suture material for primary stability under static loading and increased knots in the non-barbed suture material (knot. 220 Muscles, Ligaments and Tendons Journal 2013; 3 (3): 220-228 Suture techniques for tendon repair; a comparative review Shelley Rawson1 Sarah Cartmell1 Jason Wong2 1 Material's Science Centre, University of Manches- ter, UK 2 Plastic Surgery Research, University of Manches- ter, UK Corresponding author: Sarah Cartmel

Ideally, the suture material used should have high tensile strength, be inextensible, cause no tissue reaction and be easy to handle and knot . Flexor tendon repairs consist of two parts. The core sutures and the epitendinous sutures. Core sutures provide strength to the tendon repair Similar to the suture material mounted in the suture anchor in the first group (new), a #2 Lang, D. & Page, R. E. Flexor tendon repair in zone 2 followed by controlled active mobilisation. J. A new running-locking loop suture technique has been developed to increase tendon repair strength and to provide better tendon edge inversion. Biomechanical analysis documented the failure mechanism and the failure strength of various circumferential repair techniques. When compared with two well-known techniques, the simple circumferential running suture and Lembert running suture, the. Patients with lacerations of both flexor tendons A modified Kessler suture was used to repair the profundus tendon. The tendon of superficialis tendon was repaired with a horizontal mattress suture. In 48 fingers, the flexor tendon sheath was left open and it was closed in the second group of 42 finger

flexor tendon repair with loop sutures and locking tech- niques in order to optimize a rapid return to active mobil- ity. The purpose of this report is to describe the outcome of a multi-strand flexor tendon repair in zone 2 of a 13 month-old patient designed to maximize strength for early, active mobility. Special attention will be given t PLoS ONE (2018-01-01) . The effect of modified locking methods and suture materials on Zone II flexor tendon repair-An ex vivo study Naam NH: Staged flexor tendon reconstruction using pedicled tendon graft from the flexor digitorum superficialis. J Hand Surg. 22:323-327 1997 16. Lutsky K, Boyer M: Flexor tendon injury. Hand Surgery Update 4. 2007 American Society for Surgery of the Hand Rosemont IL 343-358 17. Pulvertaft RG: Suture material and tendon junctures results of flexor tendon repair [9]. The technique of surgical repair for zone two flexor tendon injuries has been debated extensively through the years but adhesion formation, suture rupture, and suture locking on the pulley edge remain possible consequences of a poor repair [10]. Although increasing the repair strength through increasin The coefficient of friction of nylon was lower than that of braided polyester suture (Ticron or Mersilene) (p < 0.001). The placement of knots and choice of suture material affect gliding resistance after tendon repair, and may, therefore, have an effect on the result of tendon repair. (C) 2000 John Wiley and Sons, Inc

Extensor Tendon Repair Technique: Approach ConsiderationsBiomechanics of Core and Peripheral Tendon Repairs

With these factors related to tendon repair failure considered, our department performed a pilot study using barbed sutures to repair lacerated flexor digitorum tendons. Barbed sutures (self-anchoring) have been developed by Quill Medical,in which bidirectional barbs are introduced into a suture that eliminates the need for tying a knot to. zone II and III flexor tendon injuries, and their therapeutic effects were compared to explore a better suture method for flexor tendon repairs. Materials and methods General information This study was conducted in patients diag-nosed with zone II and III flexor tendon frac-tures in Zhenjiang Ruikang Hospital from January 2014 to December 2018 To repair a torn tendon, the surgeon sews the ends of the tendon together with suture material. In some cases, if your tendon is severely damaged or diseased, your surgeon may remove the tendon and replace it with donor graft, often from your own body

A Barbed Suture Repair For Flexor Tendons: A Novel

The Winters-Gelberman 8-strand repair technique was modified by adding surface lock loops and by using Fiberwire suture material. Forty-eight canine flexor digitorum profundus tendons were transected and repaired with one of three 8-strand techniques (Pennington modified Kessler, half hitch loops, or surface locking Kessler) using either 3-0. Keywords: Flexor tendon retrieval, Atraumatic flexor tendon retrieval, Tendon retrieval, Retracted flexor tendon Background Zone 2 flexor tendon injuries still represent a challenging problem to hand surgeons despite the well developed surgical techniques and suture materials. Meticulous surgical repair with atraumatic handling of the severe The effect of knot location, suture material, and suture size on gliding resistance between the pulley and flexor tendon was investigated in a canine model. Different suture materials (monofilament nylon (Ethilon), braided polyester suture coated with silicone (Ticron) and uncoated braided polyester suture (Mersilene)) and suture sizes (4‐0, 5‐0) were tested

The Effect of Suture Materials on the Biomechanical

The CoNextions TR Implant System will be used to repair Zone 2 FDP tendon laceration (s). Active Comparator: Suture Repair. Operative repair of Zone 2 FDP tendon lacerations will be performed using a 4-strand locked cruciate repair utilizing either 3.0 or 4.0 prolene suture. Procedure: Operative repair of Zone 2 FDP tendon lacerations As illustrated in FIG. 5 a, however, in spite of their ability to minimize longitudinal tearing and/or splitting of the tendon, suture techniques such as the locking technique often result in bulky and/or knotted repair sites 16 that abut with the flexor tendon sheath's pulley system, thus impairing the tendon's ability to smoothly glide.

Flexor Tendon Repair With Looped Suture: 1 Versus 2 Knot

A technique for looped sutures in flexor tendon repair passed. Although it might appear tedious, it can be quite comfortably done when one is using a loupe magnification. A 23-gauge needle, which has a hole diameter of 0.4 mm, can easily accept a folded 4-0 or 5­ 0 prolene suture material which have a thickness of abou Subjective benefits of barbed suture material included decreased repair time, decreased length of suture material used and decreased exposure of suture material to the tendon sheath. Conclusions: Internal opposition of the surgically induced longitudinal tears of the DDFT was greater when repaired with 2-0 PDS than size 0 Stratafix

A Knotless Flexor Tendon Repair Technique Using a

Treatment of Rupture of Primary Flexor Tendon Repairs

Little collagen laid down and end to end tendon repairs are held together by the strength of the suture material (48-72 hours after repair) Right away after surgery/suture repair Strong for a few days, then weakens (strong again though in 21 days Increasing tensile strength of the lacerated tendon at the suture site is an important factor for initiating an early mobilization program. 1-5 The tensile strength of the repair can be higher when using locking loops, 6 locating the knots outside the repair site rather than inside the repair site, 7 increasing the number of suture strands. Introduction. Flexor tendon injuries are rare, however can be serious when they do occur. They typically result from a traumatic injury, such as a laceration to the volar hand surface, and therefore can occur with concurrent neurovascular injury.. Any flexor tendon hand injuries are classified based on Verdan's zones (Fig. 1). They are important to determine in any suspected tendon injury. DICTUM • Flexor tendon repair is not a surgical emergency. It is proved that equal or better results can be achieved by delayed primary repair. • Better to repair both FDP & FDS tendons rather than FDP alone Suture Materials • Core Non-absorbable 4/0 suture • Different configurations • 6/0 monofilament running epitenon suture. A device for zone-II flexor tendon repair. Surgical technique. J Bone Joint Surg Am. 2006 Mar. 88 Suppl 1 Pt 1:37-49. . Hwang MD, Pettrone S, Trumble TE. Work of flexion related to different suture materials after flexor digitorum profundus and flexor digitorum superficialis tendon repair in zone II: a biomechanical study

A Biomechanical Analysis of Suture Materials and Their

FLEXOR TENDON REPAIR SURGERY . Page 2 of 5 Patient Initials 05-01-05 version ©2005 American Society of Plastic Surgeons ®. Failure of Tendon Repair - Sutures are used to hold the tendon repair together until it has healed and has enough strength for function. It is possible to break the sutures or tear apart the tendon repair. Breakage o Flexor tendon injuries in the hand are common and surgically challenging. Verdan and Michon sent shock waves through the scientific community in the 1960s when they recommended primary repair, which to this day remains the standard treatment for these injuries. Kleinert then improved functional outcomes by proposing early protected mobilization Flexor tendon damage The flexor tendons run on the palmar/plantar aspects of the limbs and are responsible for limb support. If flexor tendons are partially damaged, weight bearing can lead to complete tears. It is important to stabilize these injuries as soon as possible to minimize further damage

Flexor Tendon Repair Plastic Surgery Ke

Whereas larger, round tendons can accommodate sutures that pass through the core of the tendon, smaller or flat tendons are difficult to repair with this technique. Most of the tendons in zone 6 can be repaired with either a modified Kessler or a modified Bunnell core suture technique using 3-0 or 4-0 nonabsorbable suture (Fig. 48-12) Differentiate intrinsic and extrinsic healing of the tendon; Distinguish the different suture techniques and implications for rehabilitation; Recognize the differences and similarities between the various protocols being used today: Kleinart, Modified Duran, Evans, and other early motion protocols. Identify key timelines in tendon healing