Influence of the Tendon Grasping Technique on Tensile Strength in 6-strand Sutures
Purpose: The locking configuration of the core suture in tendon repair considerably impacts the tendon’s tensile strength. This study assessed the effects of two grasping techniques for 6-strand core sutures on gap formation resistance using linear load-to-failure testing under simulated tendon load...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-07-01
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| Series: | Journal of Hand Surgery Global Online |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589514125000398 |
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| author | Koji Moriya, MD Yutaka Maki, MD Hisao Koda, MD Takuma Kuroda, MD Naoto Tsubokawa, MD |
| author_facet | Koji Moriya, MD Yutaka Maki, MD Hisao Koda, MD Takuma Kuroda, MD Naoto Tsubokawa, MD |
| author_sort | Koji Moriya, MD |
| collection | DOAJ |
| description | Purpose: The locking configuration of the core suture in tendon repair considerably impacts the tendon’s tensile strength. This study assessed the effects of two grasping techniques for 6-strand core sutures on gap formation resistance using linear load-to-failure testing under simulated tendon loading during active finger flexion. Methods: Forty porcine flexor tendons were assigned to 3 groups and repaired using the Yoshizu #1 (Y1) technique or our novel 6-strand Yoshizu #3 (Y3) technique with or without peripheral sutures. The Y1 and Y3 techniques had similar suture configurations, but the Y1 technique involved 4 Kessler-type tendon anchorages and the Y3 technique 2 Lim and Tsai-type tendon grasping techniques. Repaired tendons were subjected to linear, noncyclic load-to-failure tensile testing. The initial gap, 2-mm gap force, and ultimate strength were measured. Results: Tendons repaired using the Y1 technique had a significantly lower mean load at the initial gap (9.4 N) than those repaired using the Y3 technique alone (26.8 N) and the Y3 technique with peripheral sutures (81.6 N). Average load at the 2-mm gap was greater following Y3 repair alone (38.1 N) and Y3 repair with peripheral sutures (94.3 N) than Y1 repair (22.4 N). Conclusions: Significantly higher mean loads at the initial and 2-mm gap were obtained with the novel 6-strand Y3 technique compared to the 6-strand Y1 technique regardless of the use of peripheral sutures. These results suggested that Lim and Tsai-type tendon grasping is associated with greater gap resistance than Kessler-type tendon anchorage. In the Y3 technique, the use of peripheral sutures is particularly effective for enhancing the initial tension. Clinical Relevance: Surgeons should consider the impact of the tendon grasping technique on flexor tendon suturing. This novel 6-strand Y3 technique with peripheral sutures facilitates early active motion following primary flexor tendon repair. |
| format | Article |
| id | doaj-art-90ea9b4dcae94e4a8443a6ee1cece2ba |
| institution | OA Journals |
| issn | 2589-5141 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Hand Surgery Global Online |
| spelling | doaj-art-90ea9b4dcae94e4a8443a6ee1cece2ba2025-08-20T01:55:37ZengElsevierJournal of Hand Surgery Global Online2589-51412025-07-017410071910.1016/j.jhsg.2025.02.012Influence of the Tendon Grasping Technique on Tensile Strength in 6-strand SuturesKoji Moriya, MD0Yutaka Maki, MD1Hisao Koda, MD2Takuma Kuroda, MD3Naoto Tsubokawa, MD4Niigata Hand Surgery Foundation, Niigata, Japan; Corresponding author: Koji Moriya, MD, Niigata Hand Surgery Foundation, Suwayama 997, Seiro-machi, Niigata 957-0117, Japan.Niigata Hand Surgery Foundation, Niigata, JapanNiigata Hand Surgery Foundation, Niigata, JapanNiigata Hand Surgery Foundation, Niigata, JapanNiigata Hand Surgery Foundation, Niigata, JapanPurpose: The locking configuration of the core suture in tendon repair considerably impacts the tendon’s tensile strength. This study assessed the effects of two grasping techniques for 6-strand core sutures on gap formation resistance using linear load-to-failure testing under simulated tendon loading during active finger flexion. Methods: Forty porcine flexor tendons were assigned to 3 groups and repaired using the Yoshizu #1 (Y1) technique or our novel 6-strand Yoshizu #3 (Y3) technique with or without peripheral sutures. The Y1 and Y3 techniques had similar suture configurations, but the Y1 technique involved 4 Kessler-type tendon anchorages and the Y3 technique 2 Lim and Tsai-type tendon grasping techniques. Repaired tendons were subjected to linear, noncyclic load-to-failure tensile testing. The initial gap, 2-mm gap force, and ultimate strength were measured. Results: Tendons repaired using the Y1 technique had a significantly lower mean load at the initial gap (9.4 N) than those repaired using the Y3 technique alone (26.8 N) and the Y3 technique with peripheral sutures (81.6 N). Average load at the 2-mm gap was greater following Y3 repair alone (38.1 N) and Y3 repair with peripheral sutures (94.3 N) than Y1 repair (22.4 N). Conclusions: Significantly higher mean loads at the initial and 2-mm gap were obtained with the novel 6-strand Y3 technique compared to the 6-strand Y1 technique regardless of the use of peripheral sutures. These results suggested that Lim and Tsai-type tendon grasping is associated with greater gap resistance than Kessler-type tendon anchorage. In the Y3 technique, the use of peripheral sutures is particularly effective for enhancing the initial tension. Clinical Relevance: Surgeons should consider the impact of the tendon grasping technique on flexor tendon suturing. This novel 6-strand Y3 technique with peripheral sutures facilitates early active motion following primary flexor tendon repair.http://www.sciencedirect.com/science/article/pii/S25895141250003986-strand repairBiomechanicsGrasping techniqueSingle-cycle loadTensile strength |
| spellingShingle | Koji Moriya, MD Yutaka Maki, MD Hisao Koda, MD Takuma Kuroda, MD Naoto Tsubokawa, MD Influence of the Tendon Grasping Technique on Tensile Strength in 6-strand Sutures Journal of Hand Surgery Global Online 6-strand repair Biomechanics Grasping technique Single-cycle load Tensile strength |
| title | Influence of the Tendon Grasping Technique on Tensile Strength in 6-strand Sutures |
| title_full | Influence of the Tendon Grasping Technique on Tensile Strength in 6-strand Sutures |
| title_fullStr | Influence of the Tendon Grasping Technique on Tensile Strength in 6-strand Sutures |
| title_full_unstemmed | Influence of the Tendon Grasping Technique on Tensile Strength in 6-strand Sutures |
| title_short | Influence of the Tendon Grasping Technique on Tensile Strength in 6-strand Sutures |
| title_sort | influence of the tendon grasping technique on tensile strength in 6 strand sutures |
| topic | 6-strand repair Biomechanics Grasping technique Single-cycle load Tensile strength |
| url | http://www.sciencedirect.com/science/article/pii/S2589514125000398 |
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