Cyclic testing of six-strand suture techniques for zone 2 flexor tendon lacerations.

Background: Biomechanical analysis using cyclic testing for repaired flexor tendons is a clinically relevant method. The aim of this study was to evaluate the tensile properties of two six-strand suture techniques, the triple looped suture and Yoshizu #1 suture techniques using cyclic testing under simulating early active mobilization conditions.

Methods: Twenty-five flexor digitorum profundus tendons harvested from fresh frozen human cadaver hands were repaired in zone 2 utilizing one of three repair techniques: the 2-strand modified Kessler (MK) technique as a control, the triple looped suture (TLS) and Yoshizu #1 suture (Y1) techniques.

Impact of the contraction of medial forearm muscles during grip tasks in different forearm positions on medial support at the elbow joint.

We measured the medial joint distance (MJD), activity of muscles involved in medial elbow-joint support, and grip strength, aiming to examine the supportfunction of muscles. MJD was measured in supinated and pronated positions of the forearm of 10 participants under three conditions: at rest (R), under valgus load on the elbow joint (L), and under valgus load on the elbow joint during the grip task (L-grip). Under the L-grip condition, electromyography was performed on flexor digitorum superficialis (FDS), pronator teres (PT), flexor carpi radialis (FCR), and flexor carpi ulnaris (FCU); subsequently, normalized integrated electromyograms (NIEMG) were calculated.

Effects of Different Core Suture Lengths on Tensile Strength of Multiple-Strand Sutures for Flexor Tendon Repair.

Purpose: To compare 2 types of newly devised 8-strand quadruple-looped suture (QLS) techniques with a 6-strand triple-looped suture (TLS) technique; and to assess the effects of different core suture lengths (CSLs) (the length between 2 locking sites of a suture strand) within each suture row on tensile strength.

Methods: We repaired 24 flexor tendons from 12 rabbits using the TLS and QLS techniques, with equal CSL (QLS) or unequal CSL (unequal QLS) among each suture row. The QLS was composed of 4 looped sutures on the anterolateral and posterolateral aspects of the tendon.

The effect of modified locking methods and suture materials on Zone II flexor tendon repair-An ex vivo study.

The failure rate of intrasynovial tendon repair is high due to substantial elongation at the repair site and to the development of adhesions between the tendon's surface and the surrounding digital sheath. To minimize these complications, we sought to reduce the incidence of gapping and to facilitate the initiation of early motion by improving the time zero structural properties of repair. The Winters-Gelberman 8-strand repair technique was modified by adding surface lock loops and by using Fiberwire suture material.

Influence of different length of core suture purchase among suture row on the strength of 6-strand tendon repairs.

In multi-strand suture methods consisting of several suture rows, the different length of core suture purchase between each suture row may affect the strength of repairs. We evaluated the influence of the different length of core suture purchase between each suture row on the strength of 6-strand tendon repairs. Rabbit flexor tendons were repaired by using a triple-looped suture technique in which the suture purchase length in each suture row was modified.

Diagnosis of occult carpal scaphoid fracture: a comparison of magnetic resonance imaging and computed tomography techniques.

We investigated 52 consecutive patients (53 wrists) with suspected scaphoid fracture using MRI (0.2 T) within 7 days after the injury. We performed two sequences for the wrist: (1) coronal T1-weighted spin-echo and (2) T2-weighted turbo spin-echo.

Early healing of flexor tendon insertion site injuries: Tunnel repair is mechanically and histologically inferior to surface repair in a canine model.

Orthopedic injuries often require surgical reattachment of tendon to bone. Tendon ends can be sutured to bone by direct apposition to the bone surface or by placement within a bone tunnel. Our objective was to compare early healing of a traditional surface versus a novel tunnel method for repair of the flexor digitorum profundus (FDP) tendon insertion site in a canine model.

Decreased collagen organization and content are associated with reduced strength of demineralized and intact bone in the SAMP6 mouse.

Unlabelled: To examine the link between bone material properties and skeletal fragility, we analyzed the mechanical, histological, biochemical, and spectroscopic properties of bones from a murine model of skeletal fragility (SAMP6). Intact bones from SAMP6 mice are weak and brittle compared with SAMR1 controls, a defect attributed to reduced strength of the bone matrix. The matrix weakness is attributed primarily to poorer organization of collagen fibers and reduced collagen content.

Zone I flexor digitorum profundus repair: an ex vivo biomechanical analysis of tendon to bone repair in cadavera.

Purpose: Biomechanical studies of standard flexor digitorum profundus (FDP) tendon to bone repairs show ultimate strengths greater than the applied loads of early motion rehabilitation protocols. Strain data, however, indicate the potential for significant repair site gapping under these physiologic loads. Gaps in excess of 3 mm have been shown to prevent the time accrual of strength in midsubstance tendon repairs and may prevent the restoration of the normal architecture of the tendon-bone interface.

Flexor digitorum profundus tendon to bone tunnel repair: a vascularization and histologic study in canines.

Purpose: Recent in vivo canine studies have shown incomplete restoration of the flexor digitorum profundus (FDP) insertion site after transection and repair to the cortical surface of the distal phalanx. Previous biomechanical analyses of tendon to bone surface repair have suggested that repair site gap formation of greater than 3 mm occurs frequently under physiologic loads. A recent ex vivo investigation into a novel repair of the FDP tendon into a bone tunnel in the distal phalanx showed improved tensile properties with a decrease in repair site gap formation.

Bone loss following tendon laceration, repair and passive mobilization.

Little is known about the localized changes in bone mass that occur following tendon or ligament injury. Interruption of normal load transfer at the insertion site will presumably lead to a localized loss of bone, although few data exist to support this claim. To test this hypothesis, we transected the canine flexor digitorum profundus (FDP) tendon from its insertion, and either repaired it using a trans-osseous suture technique or left it unrepaired (laceration only).