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Biomechanical properties of alternative suture technique for flexor tendon repair

Treść / Zawartość
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Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Purpose: Flexor injuries are most common in the hand and require special attention and experience from the surgeon. Both quality and technique affect the stability of the suture. The selection of the optimum method will influence the process of rehabilitation. The aim of this study was to compare three different suture techniques based on the strength, depending on the method of breakage, i.e., axial or pulley load. Methods: The study was divided into six sessions. 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 additional running suture and the multistrand running suture. We obtained 120 sutures, 40 for each technique. Breaking strength was assessed using a tensile machine in two ways, i.e., axial or pulley load, with 20 sutures per group. Results: The strongest suture for both axial and pulley load was the cruciate four-strand suture. Between the multistrand running suture and the modified Kessler suture, there was no statistically significant difference in the strength of breaking for both axial and pulley load. Comparing the two ways of breaking, there was no statistically significant difference in the strength of the suture. Conclusions: The multistrand running locking suture is a good alternative to widely used core sutures. It not only provides the same strength as other techniques examined by us but also reduces the procedure time and trauma to the tips of the tendon.
Rocznik
Strony
167--172
Opis fizyczny
Bibliogr. 24 poz., rys., tab.
Twórcy
  • Department of General Orthopaedics, Oncology and Traumatology, W. Dega University Hospital, Poznań University of Medical Sciences, Poland
autor
  • Hand Surgery Department, W. Dega University Hospital, Poznań University of Medical Sciences, Poznań, Poland
  • Department of Orthopedic and Traumatology, W. Dega University Hospital, Poznań University of Medical Sciences, Poznań, Poland
autor
  • Hand Surgery Department, W. Dega University Hospital, Poznań University of Medical Sciences, Poznań, Poland
autor
  • Department of Spondyloortopaedics and Biomechanics of the Spine, W. Dega University Hospital, Poznań University of Medical Sciences, Poznań, Poland
  • Hand Surgery Department, W. Dega University Hospital, Poznań University of Medical Sciences, Poznań, Poland
Bibliografia
  • [1] DE JONG J.P. et al., The incidence of acute traumatic tendon injuries in the hand and wrist: a 10-year population-based study. Clin. Orthop. Surg., 2014, 6(2), 196–202, DOI: 10.4055/cios.2014.6.2.196.
  • [2] SEILER J., Flexor Tendon Injury, [in:] Green’s Operative Hand Surgery: Expert Consult: Online and Print. 2010, Elsevier Health Sciences, 189–207.
  • [3] SAVAGE R., RISITANO G., Flexor tendon repair using a “six strand” method of repair and early active mobilisation, J. Hand. Surg. Br., 1989, 14(4), 396–399. DOI: 10.1016/ 0266-7681(89)90154-X.
  • [4] LALONDE D.H., MARTIN A.L., Wide-awake flexor tendon repair and early tendon mobilization in zones 1 and 2, Hand. Clin., 2013, 29(2), 207–213, DOI: 10.1016/j.hcl.2013.02.009.
  • [5] WOO S.L. et al., The importance of controlled passive mobilization on flexor tendon healing. A biomechanical study, Acta Orthop. Scand., 1981, 52(6), 615–622, DOI: 10.3109/ 17453678108992156
  • [6] STRICKLAND J.W., The scientific basis for advances in flexor tendon surgery, J. Hand. Ther., 2005, 18(2), 94–110; quiz 111, DOI: 10.1197/j.jht.2005.02.013.
  • [7] GILL R.S. et al., A comparative analysis of the six-strand double-loop flexor tendon repair and three other techniques: a human cadaveric study, J. Hand. Surg. Am., 1999, 24(6), 1315–1322, DOI: 10.1053/jhsu.1999.1315.
  • [8] SCHÄDEL-HÖPFNER M. et al., Flexor tendon repair using a new suture technique: a comparative in vitro biomechanical study, Eur. J. Trauma Emerg. Surg., 2011, 37(1), 79–84, DOI: 10.1007/s00068-010-0019-8.
  • [9] STRICKLAND J.W., Flexor Tendon Injuries: I. Foundations of Treatment, J. Am. Acad. Orthop. Surg., 1995, 3(1), 44–54.
  • [10] TANG J.B. et al., Current Practice of Primary Flexor Tendon Repair: A Global View, Hand. Clin., 2013, 29(2), 179–189, DOI: 10.1016/j.hcl.2013.02.003.
  • [11] ELLIOT D., Primary flexor tendon repair – operative repair, pulley management and rehabilitation, J. Hand. Surg. Br., 2002, 27(6), 507–13, DOI: 10.1054/jhsb.2002.0800.
  • [12] BARRIE K.A. et al., A biomechanical comparison of multistrand flexor tendon repairs using an in situ testing model, J. Hand. Surg. Am., 2000, 25(3), 499–506, DOI: 10.1053/jhsu.2000.6927.
  • [13] KETCHUM L.D., Suture materials and suture techniques used in tendon repair, Hand. Clin., 1985, 1(1), 43–53.
  • [14] SMITH A.M. et al., The porcine forelimb as a model for human flexor tendon surgery, J. Hand. Surg. Br., 2005, 30(3), 307–309, DOI: 10.1016/j.jhsb.2005.02.003. \
  • [15] HUNG L.K. et al., Active mobilisation after flexor tendon repair: comparison of results following injuries in zone 2 and other zones, J. Orthop. Surg., Hong Kong 2005, 13(2), 158–163.
  • [16] POWELL E.S., TRAIL I.A., Forces transmitted along human flexor tendons during passive and active movements of the fingers, J. Hand. Surg. Eur., 2004, Vol. 29(4), 386–389. DOI: 10.1016/j.jhsb.2004.02.004
  • [17] SCHUIND F. et al., Flexor tendon forces: in vivo measurements, J. Hand. Surg. Am., 1992, 17(2), 291–298.
  • [18] DONA E. et al., Biomechanical properties of four circumferential flexor tendon suture techniques, J. Hand. Surg. Am., 2003, 28(5), 824–831. DOI: 10.1016/S0363-5023(03)00305-8
  • [19] REES L. et al., Comparison of 1- and 2-knot, 4-strand, doublemodified Kessler tendon repairs in a porcine model, J. Hand. Surg. Am., 2009, 34(4), 705–709, DOI: 10.1016/j.jhsa.2008.12.014.
  • [20] CAO Y. et al., Influence of core suture purchase length on strength of four-strand tendon repairs, J. Hand. Surg. Am., 2006, 31(1), 107–112, DOI: 10.1016/j.jhsa.2005.09.006.
  • [21] DIAO E. et al., Effect of peripheral suture depth on strength of tendon repairs, J. Hand. Surg. Am., 1996, 21(2), 234–239, DOI: 10.1016/s0363-5023(96)80106-7.
  • [22] MASHADI Z.B., AMIS A.A., Strength of the suture in the epitenon and within the tendon fibres: development of stronger peripheral suture technique, J. Hand. Surg. Br., 1992, 17(2), 172–175, DOI: 10.1016/0266-7681(92)90082-D.
  • [23] KIM P.T. et al., Tensile strength of cross-stitch epitenon suture, J. Hand. Surg. Br., 1996, 21(6), 821–823, DOI: 10.1016/S0266-7681(96)80200-2.
  • [24] NAVALI A., ROUHANI A., MORTAZAVI J., A comparative study of two suture configurations in zone II flexor tendon repair in adults, Acta Med. Iran, 2008, 46(3), 207–212.
Uwagi
Opracowanie ze środków MNiSW w ramach umowy 812/P-DUN/2016 na działalność upowszechniającą naukę (zadania 2017).
Typ dokumentu
Bibliografia
Identyfikator YADDA
bwmeta1.element.baztech-8cbec1a4-7016-43bc-ac5f-088a1401b8e0
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