Biomechanical properties of four circumferential flexor tendon suture techniques

Epitendinous Suture Techniques in Extensor Tendon Repairs—An Experimental Evaluation

“…2 The other techniques were selected for evaluation because they had been found to be superior to Silfverskiöld for flexor tendon repairs. [15][16][17][18] Our findings with the extensor tendon model are consistent with those of these authors. Although not reaching significance, the buried Silfverskiöld was stronger than the conventional Silfverskiöld, and the IHM was significantly stronger than the conventional Halsted as well as the other repairs.…”

“…15 In vitro testing suggested that an interrupted horizontal mattress (IHM) epitendinous technique might be stronger than a simple running stitch, cross-stitch, or interlocking crossstitch. 16 The IHM technique is a continuous suture that includes IHM components (Fig. 1D), a circumferential form of which has been validated for flexor tendon repairs.…”

Optimizing biomechanical performance of the 4-strand cruciate flexor tendon repair

“…These tendons, although they have a slightly greater caliber than human tendons, have a similar infrastructure and have been used successfully in other in vitro and in vivo studies. 29,30,33 The authors thank Catriona Maciver, graphic designer from the Medical Illustration Unit, Prince of Wales Hospital, Sydney. Figure 12.…”

“…In addition it examined the biomechanical gain provided by various peripheral suture techniques. The simple running, 28 crossstitch, 29 and the recently described interlocking horizontal mattress (IHM) 30 suture were examined (Fig. 2).…”

Biomechanical Study of Cross-Locked Cruciate Versus Strickland Flexor Tendon Repair

“…36 The IHM circumferential suture has demonstrated superior 2-mm gap force and ultimate load to failure when compared with a simple running or a cross-locked circumferential suture. 41 However, no studies have investigated how the inclusion of this complex circumferential suture affects the friction generated at the repair site. In addition, no studies have investigated how these biomechanical parameters are influenced by the presence of a locked versus looped core suture in combination with the circumferential suture.…”