Influence of Core Suture Geometry on Tendon Deformation and Gap Formation in Porcine Flexor Tendons

The effects of core suture geometry on the mechanics of failure in flexor tendon surgery are investigated. Forty porcine flexor tendons were repaired using a Kessler; a Kessler-Pennington; a double Kessler; a continuous Kessler; and a cruciate repair. At maximum breaking strength, the cruciate repai...

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Bibliographic Details
Published in:The Journal of hand surgery, European volume European volume, 2009-04, Vol.34 (2), p.190-195
Main Authors: WALBEEHM, E. T., DE WIT, T., HOVIUS, S. E. R., MCGROUTHER, D. A.
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Biomechanical Phenomena
Diseases of the osteoarticular system
Medical sciences
Random Allocation
Suture Techniques
Sutures
Swine
Tendons - surgery
Tensile Strength
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Summary:The effects of core suture geometry on the mechanics of failure in flexor tendon surgery are investigated. Forty porcine flexor tendons were repaired using a Kessler; a Kessler-Pennington; a double Kessler; a continuous Kessler; and a cruciate repair. At maximum breaking strength, the cruciate repair gapped more then the double Kessler (12.8 mm vs 9.1 mm), but the double Kessler was less strong (37N vs 45 N). Transverse narrowing was 22% and 24% for the Kessler and the Kessler-Pennington, 11% for the double Kessler, and 0% for the continuous Kessler and the cruciate repair. Kessler-type sutures failed by suture breakage and the cruciate repair by pull-out. Under load, the transverse part of the Kessler sutures narrows, allowing longitudinal parts to lengthen, leading to gapping. The double Kessler shortened transverse segment decreases gapping. Eliminating a transverse component (the cruciate repair) decreased gapping, but the cruciate failed at higher loads by suture pull-out.
ISSN:1753-1934
2043-6289
DOI:10.1177/1753193408098479