The four-strand staggered suture for flexor tendon repair: in vitro biomechanical study.

Purpose: To assess in vitro biomechanical properties of a 4-strand flexor tendon suture compared to 3 established suture techniques. This technique, which is made of 2 alternating and staggered sutures, one external to the tendon and the other internal, must be sufficiently resistant to withstand loads applied by modern, early active mobilization protocols.

Methods: Forty flexor hallucis longus tendons were harvested from fresh cadavers, cut, and repaired using 4 different suture techniques (Strickland, Wolfe, modified Savage, and a new technique called 4-strand staggered).