gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Asymmetric 6-Strand Flexor Tendon Repair – Biomechanical Analysis using Barbed Suture

Meeting Abstract

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  • presenting/speaker Jasmin Lee - Singapore General Hospital, Singapore, Singapore
  • Yoke Rung Wong - Singapore General Hospital, Singapore, Singapore

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-611

doi: 10.3205/19ifssh0990, urn:nbn:de:0183-19ifssh09900

Published: February 6, 2020

© 2020 Lee et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives/Interrogation: This study investigates the biomechanical performance of the Asymmetric flexor tendon repair technique using barbed suture. The Asymmetric repair technique using monofilament nylon suture was previously reported to have a higher tensile strength than the modified Lim-Tsai repair technique, but its repair stiffness and load to gap force were significantly lower. There is hence an unmet need to improve this technique and the substitution of nylon suture with barbed sutures may be the solution.

Methods: Two groups consisting of 10 porcine tendons each were repaired with the six-strand Asymmetric repair technique using V-Loc® 3-0 and Supramid® 4-0 respectively. The repairs were subjected to a mechanical tester for static testing. The ultimate tensile strength, load to 2mm gap force, repair stiffness, time taken to complete a repair and failure mechanism of the repairs were recorded and analyzed.

Results and Conclusions: All the repairs using V-Loc® 3-0 sutures had significantly higher median values of ultimate tensile strength (64.1N; 56.9N), load to 2mm gap force (39.2N; 19.7N), repair stiffness (6.4 N/mm; 4.7 N/mm) and time taken to complete a repair (9.4mins; 7.7mins). All the repairs using V-Loc® sutures failed by suture breakage while 80% of repairs using Supramid® sutures failed by suture pullout. The use of the barbed sutures in the Asymmetric repair technique, whilst more time consuming, has shown promising improvement to its biomechanical performance (i.e. better ultimate tensile strength, stiffness and resistance to gap formation).