Elsevier

The Journal of Hand Surgery

Volume 21, Issue 6, November 1996, Pages 969-973
The Journal of Hand Surgery

Effect of suture knot location on tensile strength after flexor tendon repair*,**

https://doi.org/10.1016/S0363-5023(96)80301-7Get rights and content

This study investigated the effect of increased suture material within the flexor tendon repair site on tensile strength in a canine model after in vivo healing. Four-strand modified Savage suture repairs with the knots located either inside or outside the repair site were performed in dogs. The tendons were placed on a passive-motion protocol after surgery and were biomechanically tested at 1, 3 and 6 weeks of in vivo healing. The knots-outside technique initially was 1.14 kg stronger on load-to-failure testing. After 6 weeks of healing, the knotsinside tendons had equal tensile strength (3.91±0.50 kg [inside] vs 4.16±0.66 kg [outside]). Relative tensile strength compared to initial strength showed an increase of 20% for the knots-outside technique and an increase of 67% for the knots-inside technique after 6 weeks. Suture material within the repair site did not have any deleterious effects on tensile strength and may stimulate tendon healing.

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  • Suture Tape With Broad Full-Width Core Versus Traditional Round Suture With Round Core: A Mechanical Comparison

    2019, Arthroscopy - Journal of Arthroscopic and Related Surgery
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    Our faster rate of loading, 5 mm/sec versus 1 mm/sec, may be responsible for the suture failing more rapidly and therefore at a slightly lower load in our study. Tying a knot in a suture is known to decrease the tensile strength of the suture,5,26,27 potentially resulting from damage to suture filaments at the sharp bend in the material at the knot.5,26 This phenomenon is supported by the testing of the SutureTape as the unknotted suture samples exhibited a greater ultimate load to failure than the knotted samples.

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*

This study has been supported in part by grant #15953 from the Shriner's Hospital for Crippled Children, Tampa, FL.

**

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

1

From the Department of Orthopedic Surgery, Washington University Medical School, St. Louis, MO.

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