Comparison of 1- and 2-Knot, 4-Strand, Double-Modified Kessler Tendon Repairs in a Porcine Model

Biomechanical Evaluation of Flexor Tendon Repair Using Barbed Suture Material: A Comparative Ex Vivo Study

“…Single-knot techniques are preferred to 2-knot techniques due to the lower suture volume within the repair and greater tensile strength. 34,35 The theoretical advantage is that using barbed sutures could result in increased interaction between the suture material and the tendon itself, whereby the number of strands can be reduced. Simultaneously, the unidirectional conformity of the barb could obviate the need for a knot and therefore remove any additional, potential weak spots.…”

“…Through the experimental set-up, using a tendon loop, we were able to draw from the full strength of the suture. 34 By means of a technical modification of the rod, it was possible to suture even small sections of tendon, thereby avoiding the need to couple 2 tendons.…”

Nahttechniken und Nahtmaterial in der Beugesehnenchirurgie

“…Grundsätzlich ergibt die Beschrän-kung auf einen Knoten pro Naht eine hö-here Festigkeit als mehrere Knoten [26,27] pro Naht. Als Ursachen werden eine ungleichmäßige Verteilung der Spannung in der Naht angesehen und die Abnahme der Reißfestigkeit [2] im Knoten selbst.…”

(vi) Flexor tendon injuries

“…Double Kessler, modified Becker, Tsuge). 14 The length of purchase of the core suture within the tendon substance is also important and should be a minimum of 0.7 mm but preferably 10 mm. Less than 7 mm has been shown to lead to a significant reduction in the cut out strength of the core suture.…”