Abstract
Aim: To biomechanically achieve both the most ideal and the strongest core and periferal suture method by combining 2 and 4 strand core sutures with the simple running and a new locking periferal suture techniques.
Materials and Methods: Fourty flexor digitorum pro-fundus tendons from sheep hindlimbs were studied. The tendons were then repaired using 4 different repair techniques: Group 1 – control, Group 2 – 2 strand modified Kessler’s core suture and simple running periferal suture, Group 3 – 2 strand modified Kessler’s core suture and a new multilocking loop periferal suture, Group 4 – 4 strand modified Kessler’s core suture and simple running periferal suture, Group 5 – 4 strand modified Kessler’s core suture and a new multilocking loop periferal suture. After tenoraphy all fresh sheep cadavers tendons were tested to failure using a distraction rate of 20 mm/min. Maximal strength, 2 mm gap formation force, load to failure, stiffness, method of failure and rate of tendon resistance were assessed. After and before tenoraphy, front – back and side sizes were measured.
Results: Maximal strength was 496, 32, 94, 45 and 100 Newtons for Groups 1, 2, 3, 4 and 5 respectively. There was a significantly statistical difference between the groups (p< 0.0001). Load to 2 mm gap formation was 23, 63, 36 and 72 Newtons for Groups 2, 3, 4 and 5 respectively. There was a significantly statistical difference between the groups (p< 0.0001). Load to failure was 3,783 0,285 0,505 0,41 and 0,572 Joule for Groups 1, 2, 3, 4 and 5 respectively. There was a significantly statistical difference between the groups (p< 0.0001). Tendon stiffness was 42.6, 5.16, 11.2, 5.8 and 12.6 Newton/milimetre for Groups 1, 2, 3, 4 and 5 respectively. There was a significantly statistical difference between the groups (p< 0.0001). The rate of tendon resistance was 0.97, 0.8, 1.0 and 0.91 for Groups 2, 3, 4 and 5 respectively. There was no significantly statistical difference between these groups (p=0.747> 0.05). All the simple running repairs failed by suture pullout, while all the new multilocking loop periferal suture repairs failed by suture breakage.
Conclusion: The new multilocking loop periferal suture was the best performer overall, with greater ultimate strength, load to failure, 2 mm gap formation force and stiffness.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
