Experimental Evaluation of Factors Affecting the Strength of Tendon Repairs

Ketchum, Lynn D.; Martin, Norman L.; Kappel, David A.

doi:10.1097/00006534-197705000-00014

Cited by 124 publications

(26 citation statements)

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“…24 -27 Although modified forms of the Kessler technique are what many surgeons use, numerous other techniques have been described, many of which are aimed at providing a stronger repair. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] One of the common themes of these techniques is that the strength of each is related directly to the number of strands crossing the repair site, with 4-strand repairs being twice as strong as 2-strand repairs and 6-strand repairs being almost 3 times stronger. A number of 8-strand repair techniques also have been described.…”

Section: Discussionmentioning

confidence: 99%

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

Dona

Gianoutsos

Walsh

2004

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 99%

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

Dona

Gianoutsos

Walsh

2004

The Journal of Hand Surgery

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“…Both Ketchum et al (13) and Becker (1) assessed the strength of repaired tendons with the objective of initiating early postoperative active mobilization. However, they did not evaluate the corresponding gliding function of the tendon apparatus.…”

Section: Discussionmentioning

confidence: 99%

In vitro biomechanical analysis of suture methods for flexor tendon repair

Noguchi

Seiler

Gelberman

et al. 1993

Journal Orthopaedic Research

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This study was designed to compare five different suture methods that are used clinically for tendon repair. The flexor digitorum profundus tendons from the digits of adult mongrel dogs and adult human cadavers were used as models. The tendons in zone II of the hand, defined as the region from the distal palmar crease to the insertion of the flexor digitorum superficialis tendon at the middle phalanx, were transected and then were repaired by one of the suture methods developed by Kessler, Tsuge, Tajima, Savage, or Lee. The gliding function and tensile properties of the repaired tendons were evaluated biomechanically at time zero. The Tajima and Savage methods produced better gliding function than the other techniques. In the canine specimens that had been repaired by one of these two methods, the rotation of the distal interphalangeal joint was more than 60% of the rotation of the canine control specimens; only the Savage technique produced a rotation 124% that of the human control specimens. After the Tajima repair, the rotation of the proximal interphalangeal joint was 113% that of the canine control specimens and 157% that of the human controls. In the canine specimens that had had the Tajima or Savage repair, excursion of the tendon was greater than 55% that of the controls. The tendons repaired by the Savage method tolerated a significantly higher ultimate load to failure (14 and 25% that of the canine and human control specimens, respectively) than the other methods.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…Studies of other tendons show, however, that applying tension on the sutured tendon quite early in the process of healing, after a period of primary immobilization, promotes fast recovery of tensile strength (Mason and Allen 1941, Ketchum et al 1977, Woo et al 1981, Enwemeka 1989. Experience with flexor tendons of the hand have shown that extensive tension increases adhesion formation, most likely due to ischemia (Ketchum et al 1977).…”

Section: Discussionmentioning

confidence: 99%