Evaluation of biomechanical properties on partial and complete epitendinous suture in human cadaver flexor tendon repair

J Orthop Surg Res. 2021 Aug 12;16(1):489. doi: 10.1186/s13018-021-02645-6.

Abstract

Objective: This study was designed to compare the ultimate tensile strength and force to 2 mm gap formation among 50% partial, 75% partial, and complete circumferential epitendinous suture with a combination of 4-strand core suture in human cadaver flexor tendon.

Materials and methods: Forty-five flexor tendons from four soft human cadavers were used to evaluate the biomechanical property among 50% partial, 75% partial, and complete circumferential epitendinous suture with a combination of 4-strand core suture.

Results: The force to 2 mm gap of complete epitendinous was significantly greater than partial epitendinous suture (P < 0.05); however, there was no difference between 50% partial and 75% partial epitendinous suture (P > 0.05). For the ultimate strength, there was no significant difference between partial and complete epitendinous suture (P > 0.05). The partial epitendinous was approximately 60% of the complete epitendinous suture in force to 2 mm gap and also 70% of complete epitendinous suture in ultimate tensile strength with a combination of core sutures.

Conclusions: The complete epitendinous suture showed better ultimate tensile strength and force to 2 mm gap compared with a partial 50% and 75% epitendinous suture. However, in some clinical scenario which the complete epitendinous suture is not possible to perform, the authors suggested only partial epitendinous suture with 50% circumference is recommended as the additional epitendinous repair up 75% circumference cannot provide any mechanical benefit to the repaired site.

Keywords: Complete epitendinous suture; Flexor tendon repair; Partial epitendinous suture.

MeSH terms

  • Biomechanical Phenomena
  • Cadaver
  • Humans
  • Suture Techniques
  • Sutures
  • Tendon Injuries* / surgery
  • Tendons / surgery
  • Tensile Strength