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

Tensil resistance in a tenorraphy of flexors of the hand according to the distance of the grip: pilot study in pigs

Meeting Abstract

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  • presenting/speaker Julio Sandoval - Fundacion Cardioinfantil, Bogota, Colombia
  • Nestor A. Camacho - Fundacion Cardioinfantil, Bogota, Colombia

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. DocIFSSH19-1708

doi: 10.3205/19ifssh1000, urn:nbn:de:0183-19ifssh10005

Published: February 6, 2020

© 2020 Sandoval 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: When reviewing the literature on the flexor tenorrhaphy techniques, it is not easy to determine in the study the distance of the fixation strand from the central point of each suture. We considered that this distance can be determined by the diameter of the tendon.

The purpose of this study is to make a quantification based on the diameter of each tendon.

Experimental question: What is the ideal length of the core suture purchase in the surgical repair of flexor tendon, in an experimental test carried out on the tendons of pigs?

Methods: 40 tendons of the front limb of adult pigs (Yorshire) were taken.

Four groups were taken to perform in a controlled manner. The cuts, measurement and sutures were made by the researchers. The variable in distance of the locking loop depending on the diameter of each tendon of the study was determined as follows:

I-Fixation of the point at ¼ of the diameter
II-Fixation of the point a ½ of the diameter
III-Fixation of the point to a 1 diameter
IV-Fixation of the point at 1 1/2 of the diameter

The tenorrhaphy was done with a Prolene 4-0 AT 957 suture, and the distance was quantified with a gauge. Then, the resistance was measured until failure in an Instrom 3367 machine and associated software from CITEC (Technological Research Center from the University of the Andes)

Results and Conclusions: In group I, the load at the moment of failure is at a maximum of 25,419 N, with a standard deviation of 7,151 N; in group II, the load at the time of failure is a maximum of 41.762 N, with a standard deviation of 8.525 N; in group III, the load at the time of failure is a maximum of 43,699 N, with a standard deviation of 7,835 N; in group IV the load at the maximum moment of failure is 46,497 N, with a standard deviation of 4,943 N.

Discussion: With this experimental study, it can be determined that the longer the length of the core suture purchase (distance between locking loop and lesion), the greater the resistance to the suture tension. However, in the experiment it was observed that when it is done at a distance of 1 ½ of the diameter when making the adjustment of the knot, the tendon widens by the traction of the fixed segment and this considerably increases the diameter of the repaired area, which would be an inconvenience for the good sliding of the tendon in its flexor sheath. For this reason we can recommend that the site of better resistance behavior and conservation of the anatomical feature be a diameter from the tendon.