J Korean Orthop Assoc.  1996 Apr;31(2):255-264. 10.4055/jkoa.1996.31.2.255.

Biomechanical Analysis of Tendon Suture Tecniques

• Lee KS
• Jeon JY
• Woo KJ
• Bae CH

• KMID: 2423602
• DOI: http://doi.org/10.4055/jkoa.1996.31.2.255

Abstract

Successful repair of lacerated tendons must restore continuity of the tendon and should yield a strong tenorrhaphy. Mechanical strength of repair should be adequate to early postoperative motion and mobility, The optimal repair technique must be able to withstand the rigors of early motion and also must not interfere with tendon healing. The relative strength of three suture methods of lacerated tendon were measured by mechanical disruption in effort to determine the strength of suture technique. Fifty-four Calcaneal tendons of 27 the New Zealand white rabbit were transected at mid portion and repaired with the three suture technique: group 1, Kessler suture, group 2, Pennington's modified-Kessler suture and group 3, augmented- Becker suture technique. Each group was composed of 18 calcaneal tendons. Nine rabbits were sacrified immediately after suture, nine in postoperative 2 weeks and nine in postoperative 4 weeks Six calcaneal tendons in each three experimental group were obtained immediately after suture, at postoperative 2 and 4 weeks respectively. Tensile strength, maximum strength and modulus of elasticity of all experimental specimens were measured with Instron-UTM-4-100(Toyo-Baldiwin, Japan). The results were evaluated statistically to compare the strength of the three suture technique at three different periods. The tensile strength was predominantly strongest in augmented-Becker method among three suture technique at immediate suture, postoperative 2 weeks and 4 weeks respectively. The augmented Becker repair was strongest in maximum stress among Kessler and modified Kessler repair at immediate operation, postoperative 2 weeks and 4 weeks respectively. The augmented Becker repair was highest in modulus of elasticity than Kessler method and modified-Kessler method at immediate operation, postoperative 2 weeks and postoperative 4 weeks respectively. Tensile strength, maximum stress and modulus of elasticity were gradually increased from immediate operation to postoperative 4 weeks, but there were not statistically significance between experimental three suture methods at postoperative 4 weeks.

Keyword

Tendon; Suture; Biomechanical strength

MeSH Terms

Elastic Modulus
Methods
New Zealand
Rabbits
Suture Techniques
Sutures*
Tendons*
Tensile Strength

Figure

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  Fig. 1 Schematic drawing of tendon repair technique. A. Kessler technique with 4-0 nylon, B. Pennington’s modified Kessler technique with core stitch of 4-0 nylon and epitenon - first suture with 5-0 vicryl. C. Augmented - Becker repair with two rows of criss-crossing 4-0 nylon and epitenon - first suture with 5-0 vicryl.

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  Fig. 2 Instron Model UTM-4-100 (Toyo-Baldiwin, Japan)

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  Fig. 3 Schematic drawing of ten don clip in 15 mm width.

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  Fig. 4 Mean value of maximum load according to three suture methods.

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  Fig. 5 Mean value of maximum strength according to three methods.

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  Fig. 6 Mean value of modulus of clasticity according to three suture methods.

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