Flexor tendon repair with a knotless, bidirectional barbed suture: an in vivo biomechanical analysis

The Journal of Hand Surgery
Grady E MaddoxBrent Ponce

Abstract

To compare and analyze biomechanical properties and histological characteristics of flexor tendons either repaired by a 4-strand modified Kessler technique or using barbed suture with a knotless repair technique in an in vivo model. A total of 25 chickens underwent surgical transection of the flexor digitorum profundus tendon followed by either a 4-strand Kessler repair or a knotless repair with barbed suture. Chickens were randomly assigned to 1 of 3 groups with various postoperative times to death. Harvested tendons were subjected to biomechanical testing or histologic analysis. Harvested tendons revealed failures in 25% of knotless repairs (8 of 32) and 8% of 4-strand Kessler repairs (2 of 24). Biomechanical testing revealed no significant difference in tensile strength between 4-strand Kessler and barbed repairs; however, this lack of difference may be attributed to lower statistical power. We noted a trend toward a gradual decrease in strength over time for barbed repairs, whereas we noticed the opposite for the 4-strand Kessler repairs. Mode of failure during testing differed between repair types. The barbed repairs tended toward suture breakage as opposed to 4-strand Kessler repairs, which demonstrated suture pullout. Hi...Continue Reading

References

Nov 1, 1996·The Journal of Hand Surgery·D L PruittP R Manske
Jan 23, 1999·Plastic and Reconstructive Surgery·A AkaliA D McGrouther
Nov 14, 2000·Journal of Biomedical Materials Research·T MomoseK N An
Jul 27, 2001·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·A WadaY Iwamoto
May 3, 2006·Plastic and Reconstructive Surgery·Amy P MurthaGregory L Ruff
Dec 17, 2009·Plastic and Reconstructive Surgery·Pranay M ParikhJames P Higgins
Feb 22, 2011·JSLS : Journal of the Society of Laparoendoscopic Surgeons·Jon I EinarssonJames A Greenberg
Mar 5, 2011·The Journal of Hand Surgery·Philip H ZeplinKarsten Schmidt
Jun 15, 2011·The Journal of Hand Surgery·Ian C Marrero-AmadeoGregory A Merrell
Mar 21, 2012·The Open Orthopaedics Journal·M GriffinW Khan

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Citations

Apr 23, 2016·PloS One·Ioannis KormpakisRichard H Gelberman
Apr 21, 2017·Hand : Official Journal of the American Association for Hand Surgery·Aakash ChauhanBradley A Palmer
Mar 5, 2016·The Journal of Hand Surgery, European Volume·F P O'BrienK R Means

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