Fine tuning of the side-to-side tenorrhaphy: A biomechanical study assessing different side-to-side suture techniques in a porcine tendon model

Abstract

Recent studies conclude that a new technique for tendon transfers, the side-to-side tenorrhaphy by Fridén (FR) provides higher biomechanical stability than the established standard first described by Pulvertaft (PT). The aim of this study was to optimize side-to-side tenorrhaphies. We compared PT and FR tenorrhaphies as well as a potential improvement, termed Woven-Fridén tenorrhaphy (WF), with regard to biomechanical stability. Our results demonstrate superior biomechanical stability and lower bulk of FR and, in particular, WF over PT tenorrhaphies. The WF and FR technnique therefore seem to be a notable alternative to the established standard tenorrhaphy as they display lower bulk and higher stability, permitting successful immediate active mobilization after surgery.

Restoring Function of the Flexor Tendons of the Hand: State of the Science in Kazakhstan

“…Effective exposure during the tendon anastomosis is vital to ensuring a successful tendon repair. Some researchers have concluded that the strength and elasticity of the tendon anastomosis are equal to the size and volume of the sutures applied to it (Rawson et al, 2013; Wilhelm et al, 2021).…”

Finding the Optimal Surgical Incision Pattern—A Biomechanical Study

“…In this study we established an in vitro model to objectively assess the stability of skin samples with or without various incision patterns. Similar models (including endpoints and clinimetrics) have been successfully used in the past, in particular, to assess the stability of tendon sutures and tenorrhaphies [14,29,30]. However, the findings of our study are significantly limited by its (in vitro) set-up.…”

“…Means and standard deviations were calculated for the different groups. Tensile testing was filmed using a Legria HF M31 video camera (Canon Co., Ltd., Ohta-ku, Tokyo, Japan) to document the mode of failure (pull-out vs. suture breakage) [14]. Considering the cost for acquisition and maintenance of the biomechanical testing equipment as well study-specific materials (skin samples, suture material, 3D-printed incision-pattern templates) the average cost per skin sample tested was approximately EUR 4.80.…”

European Board of Hand Surgery (EBHS) Examination Questions

“…(2022) suggest that three is the optimal number, exact technical details) or a Friden weave or alternative (Graham et al., 2022; Pulvertaft, 1956). A knowledge of the literature comparing the various suture techniques will gain extra marks (for instance Bidic et al., 2009; Brown et al., 2010; Wilhelm et al., 2021). You will need to know what suture to use and how you are going to judge the tension of repair.…”