Journal of Hand Surgery

Winters S.C., Gelberman R.H., Woo S.L-Y., Chan S.S., Grewal R., Seiler J.G


This study was designed to determine the effects of in vivo multistrand, multigrasp suture techniques on the strength and gliding of repaired intrasynovial tendons when controlled passive motion rehabilitation was used. Twenty-four adult mongrel dogs were divided into 4 groups and their medial and lateral forepaw flexor tendons were transsected and sutured by either the Savage, the Tajima, the Kessler, or the recently developed 8-strand suture method. The tendon excursion, joint rotation, and tensile properties of the epaired tendons were evaluated biomechanically at 3 and 6 weeks after surgery. it was found that neither time nor suture method significantly effected proximal and distal interphalangeal joint rotation or tendon excursion when the 4 techniques were compared to each other. normalized load value (experimental/control) was significantly affted by both the suture method and the amount of time after surgery, however. The Savage and 8-strand repair methods had significantly greater strength than did the Tajima method at each time interval (p>0.05 for each comparison). In addition, the 8-strand repair method had significantly greater normalized load values than did the Savage method at each time interval (p<0.05 for each comparison). Normalized stiffness (experimental/control) for the 8-strand repair method was significantly greater than that for the Tajima and Savage methods at 3 and 6 weeks after surgery (p<0.05). In addition, the normalized stiffness values for the 6-week groups was significantly greater than those for the 3-week groups (p<0.05). It was concluded that the method of tendon suture was a signiciant variable insofar as the regaining of tendon strength was concerned and that the newer low-profile 8-strand repair method signiciantly expands the safety zone for the application of increased in vivo load during the early stages of rehabilitation.