Format

Send to

Choose Destination
J Hand Surg Am. 2011 Mar;36(3):450-5. doi: 10.1016/j.jhsa.2010.11.029. Epub 2011 Feb 17.

Influence of locking stitch size in a four-strand cross-locked cruciate flexor tendon repair.

Author information

1
Surgical and Orthopaedic Research Laboratories, University of New South Wales, Prince of Wales Hospital, Sydney, Australia.

Abstract

PURPOSE:

The 4-strand cross-locked cruciate technique (Adelaide technique) for repairing flexor tendons in zone II is a favorable method in terms of strength and simplicity. The purpose of this study was to investigate the effects of varying the cross-lock stitch size in this repair technique. Outcomes measured were load to failure and gap formation.

METHODS:

We harvested 22 deep flexor tendons from adult pig forelimbs and randomly allocated them into 2 groups. After cutting the tendons at a standard point, we performed a 4-strand cross-locked cruciate repair using 3-0 braided polyester with either 2-mm cross-locks (n = 11) or 4-mm cross-locks (n = 11). All repairs were completed with a simple running peripheral suture using 6-0 polypropylene. Repaired tendons were loaded to failure and the mechanism of failure, load to failure, stiffness, and load to 2-mm gap formation were determined.

RESULTS:

All repairs failed by suture breakage; we noted no suture pullout. There was no difference in load to failure (71.7-71.1 N; p = .89) or stiffness (4.1-4.6 N/mm; p = .23) between the 2-mm cross-lock and the 4-mm cross-lock groups. There was a trend toward higher resistance to 2-mm gap formation with the 4-mm cross-locks (55-62.2 N; p = .07).

CONCLUSIONS:

Four-strand cross-locked cruciate repairs with cross-lock sizes of 2 and 4 mm provide high tensile strength and are resistant to pullout. Repairs with 4-mm cross-locks tend to provide a more central load distribution and better gapping resistance than repairs with 2-mm cross-locks.

PMID:
21333462
DOI:
10.1016/j.jhsa.2010.11.029
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center