Abstract
Introduction The aim of this study was to determine the biomechanical properties of various combinations of four-strand core and peripheral suture techniques used in flexor tendon repairs.
Methods Seventy-two sheep flexor tendons were randomly divided into nine groups of eight. Tendons were sharply transected and repaired using three different four-strand core techniques: cruciate, modified-Kessler, and the modified Becker. These were combined with three different peripheral techniques: simple running, cross-stitch, and the recently described interlocking horizontal mattress (IHM). Tendons from these nine groups were loaded onto a materials testing machine and tested to failure using a crosshead speed of 20 mm/min. Load to two millimetre gap formation, load to failure, and stiffness was assessed. Data was analysed using ANOVA on SPSS for Windows.
Results For any given type of peripheral suture, no significant difference in biomechanical properties was found between the three core repair techniques. The only factor causing a significant difference in strength of the tendon repair was the type of peripheral suture technique used. Repairs with an IHM technique had significantly greater loads to 2 mm gap formation, load to failure, and stiffness, compared to the cross-stitch and simple running methods.
Conclusions This study demonstrates the superior biomechanical properties of the IHM technique. Increasing core suture complexity does not appear to have a significant impact on the overall mechanical integrity of the repair. These results should be considered when adopting a preferred repair technique.
The abstracts were prepared by Mr Jerzy Sikorski. Correspondence should be addressed to him at the Australian Orthopaedic Association, Ground Floor, William Bland Centre, 229 Macquarie Street, Sydney NSW 2000, Australia.
None of the authors have received any payment or consideration from any source for the conduct of this study.
