Comparative Tensile Load Study of Loop, Interweave, and Kessler Suture Technique using Long Flexor Tendon of Chicken

Kim, Sae Hoon; Baek, Goo Hyun; Gong, Hyun Sik; Chung, Moon Sang

Abstract

OBJECTIVES
The purpose of this study is to compare ultimate tensile load of newly designed loop suture technique, to those of Pulvertaft fishmouth suture technique and Kessler suture technique with core strands.
MATERIALS AND METHODS
Eight week-old Habbard chickens were sacrificed to harvest flexor digitorum logus tendon of long toe. They were divided into four groups according to suture technique; interweave suture group, loop suture group, Kessler suture group, and normal control group. Twenty tendons were tested in each group. Comparison of cross-sectional areas between each technique was verified by statistical method and the difference was not statistically significant (p>0.05). Tensile load and deformed length were checked by Instron (Model 1000, Instron Corp, Canton, MA). ANOVA test was used for statistical analysis.
RESULTS
Ultimate tensile loads were 22.83+/-7.89 N in interweave suture group, 30.58+/-5.96 N in loop suture group, and 10.83+/-4.47 N in Kessler suture group. These results showed statistically significant differences (p<0.001). The values were 33 % in interweave suture, 44% in loop suture, and 15 % in Kessler's suture respectively. Absorbed energy were 0.48+/-0.32 J in interweave suture group, 0.61+/-0.18 J in loop suture group, and 0.22+/-0.15 J in Kessler suture group, and 1.01+/-0.20 J in normal control group. There were statisti - cally significant differences between each groups (p<0.01).
CONCLUSION
The loop suture technique showed better biomechanical properties than interweave or Kessler technique. We think the loop suture technique is a simple and useful method, especially for tendon transfer or tendon graft when tendon length is sufficiently long to make a good tendon overlap.