Primary Repair of Flexor Tendons

The search for the ideal tendon repair in zone 2: strand number, anchor points and suture thickness

“…Verdan (1960) managed the adhesion problem by cross pins through the tendon at a distance from the cut and a fine 'arterial' peripheral suture (Figure 1(C)); the sheath at the repair site was excised for 2.5 cm to prevent adhesion. Kleinert et al (1973) used a short criss-cross core suture (essentially a short Bunnell suture) and a peripheral suture, with fine 5-0 and 6-0 sutures, respectively (Figure 1(D)). Kleinert et al (1981) later reported the modified Kessler core suture and used 3-0 braided polyester and 4-0 polyamide.…”

The effect of core suture flexor tendon repair techniques on gliding resistance during static cycle motion and load to failure: a human cadaver study

“…All the core sutures used 4-0 braided polyblend suture (FiberWire Arthrex, Inc. Naples, FL, USA). A simple continuous epitendinous suture was performed using a 6-0 monofilament polypropylene (Prolene, Ethicon, Somerville, NJ, USA) (Kleinert et al, 1973). The simple running epitendinous throws were approximately 2 mm from the lacerated tendon ends, with approximately 1 mm between each throw.…”

Performance of a knotless four-strand flexor tendon repair with a unidirectional barbed suture device: a dynamic ex vivo comparison

“…The best approach for restoring flexor tendon function after injury has evolved with time. Primary repair with a core and peripheral suture is now standard (Kleinert et al, 1973;Strickland, 1995). Multi-strand core suture techniques are ideal, although contention exists regarding the ideal number of strands Gill et al, 1999;McDonald et al, 2013;Thurman et al, 1998;Viinikainen et al, 2004).…”