Flexor tendon repair using a “six strand” method of repair and early active mobilisation

Abstract

A "six strand" method of tendon repair has been used to treat 36 fingers with flexor tendon lacerations. Following surgery, active mobilisation in a protective splint was begun immediately. 63% of lacerations were in zone 2 and 27% in zone 1. 69% and 100% respectively achieved an excellent or good result using Buck-Gramcko's assessment method. 81% of all the fingers were rated excellent or good.

Suture techniques with high breaking strength and low gliding resistance: Experiments in the dog flexor digitorum profundus tendon

“…To achieve a breaking strength which exceeds light grasping and pinching forces, newer suture techniques with increased holding ability, such as the Becker (1978) marginal suture, the double-loop locking suture (Lee 1990), the 6-strand Savage suture (Savage and Risitano 1989), and cruciate repair (McLarney et al 1999, Barrie et al 2000 have been developed. The classic Kessler method has also continued to be modi ed.…”

Gliding characteristics of tendon repair in canine flexor digitorum profundus tendons

“…Early controlled mobilization, either active or passive, after flexor tendon repair has been widely acknowledged as an effective postoperative therapy to minimize adhesions and improve tendon gliding [33,39]. The key to this therapy is to maintain tendon gliding within the sheath, especially before adhesion formation or in the early stages when the adhesion is easy to break after tendon repair.…”

“…Early motion after tendon repair, either active or passive, has been shown to reduce adhesion formation and increase the tensile strength of the healing tendon [5,10,33,40,41]. However, early motion may also have the detrimental effect of contributing to gap formation or suture rupture [ 13,27,36,38].…”

Nahttechniken für Beugesehnen der Hand

“…Multistrangnahttechniken, die zusätzlich noch einen Teil der Sehnenfasern umfassen ("grasping") oder blockierend umfassen ("locking"), zeichnen sich durch eine deutlich erhöh-te Reißkraft aus [69]. Die Arbeiten von Savage [50,51], Komanduri et al [28], Silfverskiöld und Andersson [54], Shaieb und Singer [53] zeigen, dass sich die Festigkeit einer Sehnennaht in etwa proportional zur Anzahl der Kernnahtfäden verhält, die die Rupturstelle überbrücken. Diese erhöhte Reißfestigkeit behält die Sehne während der gesamten Dauer der Sehnenheilung.…”