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A Sensitive Method to Quantify Gap Formation of Tendon and its Use in Mechanical Investigation of Tendon Repair
Ya Fang Wu, MD
Department of Hand Surgery, The Hand Surgery Research Center, Affiliated Hospital of Nantong University, Nantong, China

Introduction: We used a sensitive method to evaluate the biomechanical properties of an asymmetric core suture for tendon repair, i.e., 2 sets of separate repairs, each with asymmetric length of purchase on 2 tendon stumps.

Methods: Sixty porcine flexor tendons were repaired with 3 4-strand sutures with different core suture purchases respectively: 2 sets of identical purchases of 10 mm, 2 sets of asymmetric purchases, and 2 sets of identical purchases of 12 mm. The tendons were subjected to the cyclic loading for 20 cycles. The number of tendons with gaps at each cycle, the elongation of gap area between tendon ends and tendon segment, the gap formation forces, and the ultimate strengths were obtained by accurately measurement using digital photography and computational software Results Tendons repaired with the asymmetric core suture purchases had the smallest gaps during the cyclic loading process. The elongation of gaps and tendon segments were significantly smaller than those with symmetric suture purchase of 10 mm. The asymmetric core suture repair had significant higher gap formation forces than this symmetric suture repair at the final loading cycle. Conclusions A 4-strand core suture repair with asymmetric lengths of suture purchases on the 2 repaired tendon stumps generates greater gapping resistance than that with equal length of suture purchase. The asymmetric core suture purchase may be a practical measure to improve gapping resistance and fatigue strength when the suture purchase meet essential length requirements. The proposed measurement represents a sensitive and objective way to quantify tendon elongation and gap sizes in tendon repairs.


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