We used 144 tendons which were partially divided and then repaired by a modified Kessler technique. Tendon repair if not done properly can lead to suboptimal results and compromised functions.This vid. Evaluation of hollow mesh augmentation on the biomechanical properties of the flexor tendon repaired with modified Kessler technique. Human amniotic membrane is used to prevent peritendinous adhesions after tendon injuries. Authors . Modified Kessler 2 core - YouTube Repair of extensor tendon cuts on the dorsal surface of the hand and forearm were associated with better results in zones 3 and 5 than in zones 1, 2 and 4. Biomechanical testing. Online ahead of print. This study compares the mechanical properties of modified Kessler repairs and modified Kessler repairs strengthened using multiple layers of human amniotic membrane.Methods:. Suture techniques for tendon repair; a comparative review Twenty flexor digitorum profundus tendons of sheep forelimbs were sutured by the two-strand modified Kessler technique . Purpose: To compare the biomechanical properties of the modified Kessler, Lahey, Adelaide, and Becker repairs, which are marked by either a locking-loop or a cross-lock configuration. The tendon position was then maintained by the placement of a fine (25-gauge) needle through the tendon and adjacent soft tissues. Tendon injury is extremely common in both hand and feet. Twenty human flexor digitorum profundus (FDP) tendons were randomly assigned to the . Surgical technique: A 1-knot and B 2-knot 4-strand double-modified Kessler tendon repair; C diagram showing knots of A and B. repair groups, including the modified Kessler tech- nique, six-strand Savage technique, and a strengthened modified Kessler technique, all combined with an epi- tendinous suture. The value of P <0,05 was taken a significance limit. We used 144 tendons which were partially divided and then repaired by a modified Kessler technique. Methods 128 fingers of 89 patients who had flexor tendon laceration in zone 2 built the working group. Repair by the modified Kessler suture method provides proper stability at the site of the tendon cut. For Tsuge and modified Kessler repairs, braided polyester suture use appears more advantageous compared to monofilament polydioxa- Biomechanical Analysis of the Modified Kessler, Lahey, Adelaide, and Becker Sutures for Flexor Tendon Repair . Fiberwire suture improved maximum load, the load necessary to create a 2 mm repair site gap, stiffness, and yield force compared to Supramid suture. There are a number of factors that have been shown to affect the outcomes of tendon repair. Specimens were loaded to failure. Results Group A: Avarage 3mm separation value 29.9 ± 2.9 N, average rupture resistance 37.0 ± 4.0 N Authors . Publication types Comparative Study English Abstract MeSH terms Animals Biomechanical Phenomena Introduction: : Hand Tendon injuries are not uncommon. Flexor tendon repair Kesslerstandard modified Kessler technique. Methods: Sixty sheep Achilles tendons were cut transversely as a substitute for rupture and repaired using modified Kessler, Bunnell and Tsuge techniques with No . Tendon suturing techniques. The purpose of this study was to describe a modification of the Massachusetts General Hospital (MMGH) tendon repair and to compare it with three other suture techniques. Each group was subjected to biome- chanical tests and the maximum strength of the tendons to rupture and the power exerted to yield a 3-mm sepa- ration were recorded. Objectives: To compare functional outcome of tendon repair with Modified Kessler and four strand cruciate techniques. Liu H(1)(2), Thoreson A(1), Kadar A(1), Moran S(1), Zhao C(1). Modified Kessler technique was performed in all tendons repairs. 2021 Jun 5. doi: 10.1007/s00167-021-06613-9. Schematic diagrams of both repairs are as shown in Figure 1. figure 1:(A) Modified Kessler repair, (B) For Strand Cruciate Repair. The repair strength is the most important factor as the main function of the tendon is to transmit force, hence a repair must withstand the high forces applied by early active mobilisation15.This has led to an abundance of different suturing techniques described in the . These biomechanical properties may allow safe and active motion without any gap formation in the repair area. Materials and Methods. Online ahead of print. All testing was carried out on an uniaxial materials testing machine (Denison Mayes Group, Leeds, UK). Author information: (1)Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA. The surface locking Kessler technique improved repair maximum load, load necessary to create a 2 mm repair site gap, and yield force compared to the modified Kessler and half hitch loop techniques. Objective of this randomized controlled trial was to compare functional outcome of tendon repair with Modified Kessler as compared to four strand cruciate technique. Thirty eight out of 50 (76%) patients recovered fully and regained full range of pain free movement at wrist and fingers in 8 to 12 weeks time. Methods: Ninety-six lacerated porcine flexor tendons were repaired using the respective core suture and an epitendinous repair. These biomechanical properties may allow safe and active motion without any gap formation in the repair area. Bunnell and modified Kessler techniques are among the preferred procedures for open and percutaneous Achilles tendon repairs (ATRs), and the efficacy of both techniques has been evaluated in numerous biomechanical and clinical studies (3, 5-15). There are a number of factors that have been shown to affect the outcomes of tendon repair. Moving away from original to modified Kessler tendon repair is likely unwise J Hand Surg Eur Vol. The various locking configurations may have individual mechanical properties in end-to-end flexor tendon repair.1, 21, 22, 23 Some of the previous studies claimed a superior repair strength for the cross-lock. The tendons were assigned to three in situ repair groups, including the modified Kessler technique, six-strand Savage technique, and a strengthened modified Kessler technique, all combined with an. The transverse components of the repairs are 7 mm and 10 mm from the repair site. The "grasping technique" described by Isidor Kessler and Fuad Nissim in 1969 is a popular method of flexor tendon repair. Tendon injury is extremely common in both hand and feet. Tendons were randomly assigned to 1 of 4 groups with 24 specimens per group. Objective of this randomized controlled trial was to compare functional outcome of tendon repair with Modified Kessler as compared to four strand cruciate technique. Bunnell and modified Kessler techniques are among the preferred procedures for open and percutaneous Achilles tendon repairs (ATRs), and the efficacy of both techniques has been evaluated in numerous biomechanical and clinical studies (3, 5-15). Conclusion: This study supports the opinion that Tsuge technique is a promising procedure in Achilles tendon repair (ATR). Online ahead of print. Results: T h e evaluation of the results is based on TAM (Total Active Motion) score of the ASSH (American Society for Surgery of the Hand). Introduction: : Hand Tendon injuries are not uncommon. Flexor tendon repair Kesslerstandard modified Kessler technique. 2022 Jan 8;17531934211070699. doi: 10.1177/17531934211070699. The purpose of this study was to describe a modification of the Massachusetts General Hospital (MMGH) tendon repair and to compare it with three other suture techniques. Tendon suturing techniques. suture in the modified Kessler repairs with respect to YM (p=.003). The "grasping technique" described by Isidor Kessler and Fuad Nissim in 1969 is a popular method of flexor tendon repair. The Achilles tendon is the thickest and strongest tendon in the human body, and one of the most commonly ruptured (1, 2).Acute rupture of the Achilles tendon can be managed with conservative or surgical methods, but the optimal treatment approach remains controversial (3-8).Bunnell and modified Kessler techniques are among the preferred procedures for open and percutaneous Achilles tendon . 2021 Jun 5. doi: 10.1007/s00167-021-06613-9. The tendons were transversely cut and then repaired using six different techniques, the MK method, double knot Kessler-loop lock flexor tendon suture (DK), and single knot Kessler-loop lock flexor tendon suture (SK), each in combination with the epitendinous suture (P), and the same three techniques without P. There were four test groups: group 1, simple tendon repair, group 2, repair site wrapped with amniotic membrane, group 3, hyaluronic acid injected around the repair site, and group 4, repair site wrapped with amniotic membrane and hyaluronic acid . Tendon repair with the strengthened modified Kessler technique provides the highest resistance to both 3-mm separation and rupture. There were four test groups: group 1, simple tendon repair, group 2, repair site wrapped with amniotic membrane, group 3, hyaluronic acid injected around the repair site, and group 4, repair site wrapped with amniotic membrane and hyaluronic acid . Acknowledgment. Modified triple Kessler with least risk of elongation among Achilles tendon repair techniques: a systematic review and network meta-analysis of human cadaveric studies Knee Surg Sports Traumatol Arthrosc. Biomechanical testing was conducted under static and cyclic loads. The aim of the study is to retrospectively examine the results of 4-strand modified Kessler core suture and epitendinous interlocking suture repair technique followed by modified Kleinert protocol and the effects of the factors such as follow-up time, co-existing injury existence, time of repair, single or multiple finger injury, tendon rupture . Different authors have modified this technique to the point where the so-called "modified Kessler technique" bears little resemblance to the original description. Tendon repair if not done properly can lead to suboptimal results and compromised functions.This vid. Different authors have modified this technique to the point where the so-called "modified Kessler technique" bears little resemblance to the original description. P iskin et al. Methods: Ninety-six lacerated porcine flexor tendons were repaired using the respective core suture and an epitendinous repair. The repair strength is the most important factor as the main function of the tendon is to transmit force, hence a repair must withstand the high forces applied by early active mobilisation15.This has led to an abundance of different suturing techniques described in the . Mean time of recovery was 8.8 days + 1.319 SD. 2 braided polyester and monofilament polydioxanone sutures. Background:. Methods: Sixty sheep Achilles tendons were cut transversely as a substitute for rupture and repaired using modified Kessler, Bunnell and Tsuge techniques with No. 7, 15 The knot lies in the transverse component of the suture, and the suture is anchored with 8 locking loops. Modified triple Kessler with least risk of elongation among Achilles tendon repair techniques: a systematic review and network meta-analysis of human cadaveric studies Knee Surg Sports Traumatol Arthrosc. Objectives: To compare functional outcome of tendon repair with Modified Kessler and four strand cruciate techniques. grasping of the tendon through the paratenon was avoided. Purpose: To compare the biomechanical properties of the modified Kessler, Lahey, Adelaide, and Becker repairs, which are marked by either a locking-loop or a cross-lock configuration. Different authors have modified this technique to the point where the so-called "modified Kessler technique" bears little resemblance to the original description. Modified Kessler technique for primary repair of acute flexor tendons injuries were used in both groups added by the cephalic vein as a tendon sheath substitute in the test group. Tendon repair with the strengthened modified Kessler, modified Kessler, andSavage suture techniques 241 (ANOVA) and Post hoc Tukey HSD tests were used. Objective: The aim of this study was to compare the biomechanical properties of modified Kessler, Bunnell and Tsuge techniques in sheep Achilles tendon tear repaired using polyester and polydioxanone sutures which are also compared. Group 1 tendons were repaired with a 4-strand modified Kessler suture ( Fig. Flexor tendon repair simulation with 2-strand Modified Kessler, 4-Strand Cruciate and common errors, simulated on porcine tissue and hollow tube. Biomechanical testing was conducted under static and cyclic loads. Flexor tendon repair was performed using modified two strand Kessler method core suture with a round needle 3.0 polypropylene The surface locking Kessler technique improved repair maximum load, load necessary to create a 2 mm repair site gap, and yield force compared to the modified Kessler and half hitch loop techniques. Conclusion: Tendon repair with the strengthened modified Kessler technique provides the highest resistance to both 3-mm separation and rupture. 1 ), in which the knot is buried inside the tendon. Authors Qian Qian Yang 1 , Jing Chen 1 Affiliation 1 . These biomechanical properties may allow safe and active motion . The "grasping technique" described by Isidor Kessler and Fuad Nissim in 1969 is a popular method of flexor tendon repair. A 300 N load . Tendon repair was performed within 24 hours of admission in all patients. Achieving a satisfactory range of motion and preventing tendon rupture after repair of flexor tendon injuries remains a challenge to hand surgeons.. Tendon repair with the strengthened modified Kessler technique provides the highest resistance to both 3-mm separation and rupture. Schematic diagrams of both repairs are as shown in Figure 1. figure 1: (A) Modified Kessler repair, (B) For Strand Cruciate Repair Materials and Methods Achieving a satisfactory range of motion and preventing tendon rupture after repair of flexor tendon injuries remains a challenge to hand surgeons.. Twenty human flexor digitorum profundus (FDP) tendons were randomly assigned to the . The results of zone 2 flexor tendon lacerations repaired primarily by 4 strand Modified Kessler core suture and epitendinous interlocking suture technique followed by Modified Kleinert protocol were investigated.
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