#5 … 35, 36 These flexor tendon repair methods were specifically designed with conventional suture materials in mind. There are a number of factors that have been shown to affect the outcomes of tendon repair. Half inch Steri-Strips were cut in half and used to approximate skin edges as well. The transverse intertubercle ligament was released. - Gliding and gap formation for locking and grasping tendon repairs: a biomechanical study in a human cadaver model. Previous studies have compared strength of repair and gliding resistance for various braided suture materials and for 100% laceration of flexor tendons. A probe is then used to iden-tify the remaining longitudinal split in the tendon. 6-0 Prolene. A technique for looped sutures in flexor tendon repair passed. Absorbable sutures in tendon repair. A comparison of PDS ... Tendon Subcutaneous tissue was closed with 2-0 Vicryl in interrupted fashion, skin edges approximated with 3-0 Prolene in a subcuticular manner. Suture Materials - Core EM Flexor tendon repair is ideally performed by trained surgeons who know the anatomy of the flexor tendon system and the potential pitfalls of surgical repair. Prolene 6-0, for example, is a commonly used option to suture facial wounds where the cosmetic outcome is key, as the low reactivity is thought to cause less scarring. Prolene is also used routinely for vascular anastomoses, abdominal wall closure and in caesarean sections. It is often dyed blue to aid visibility. Do people really use catgut? Osada D, Fujita S, Tamai K, et al. They could show similar gap formation force in comparison to the control group using Ethibond™ as … It is generally accepted that if one uses sutures to repair an uncomplicated laceration, the best choice is a monofilament non-absorbable suture. Zone 2 Flexor Tendon Repair With CoNextions TR Implant ... The average follow-up was 1.5 years. Suture Material Types - Geeky Medics Operative repair of Zone 2 FDP tendon lacerations will be performed using a 4-strand locked cruciate repair utilizing either 3.0 or 4.0 prolene suture. Do tendon sutures dissolve? It is recommended to use the Lindholm technique (gastrocnemius aponeurosis turn-down flap) to repair the defect of the Achilles tendon rupture ends. Tension-free core suture repair was performed with a modified-Kessler, 4-strand repair using a double-stranded 4-0 Supramid suture. The two sutures The defects were ex- All the polyester fibre based sutures performed extremely well, with Mersilene proving to be the best overall. Here's the post-operative dressing holding the wrist bent down towards the floor to protect the tendon. a) Central cut wound of the volar aspect of right wrist at tendon zone 5, b) Exploration of the wound and complete the examination under general anesthesia was done, c) Identification of distal and proximal tendon ends, d) Repair of tendons by modified Kessler repair with 4 core sutures with prolene 4/0, e-f) Median nerve repair with prolene 7/0. A circumferential suture with Prolene (Ethicon, Somerset, NJ, USA) is then placed in an interlocking horizontal mattress fashion (Fig. published their research data in 2009, where they used a 2-0 barbed bidirectional non-absorbable polypropylene suture (Quill™) for flexor tendon repair FiberWire's superior strength and reliability makes FiberWire an ideal choice when … suture, and a running circumferential suture of 6-0 Prolene. Immediately after a tendon repair, the tendon contributes nothing to the strength of repair. The ruptured ends of the tendon are cleaned and any dead or damaged tissue is removed. Methods: Sixty-four fingers in 54 patients with zone 2 flexor tendon modified Kessler repairs were enrolled in a prospective At that stage, there was no significant difference between tendons repaired with PDS, and Prolene repairs. Despite both studies reporting Prolene (Ethicon Ltd, Edinburgh, United Kingdom) monofilament and nonabsorbable sutures were used for all ex vivo experiments. The CoNextions TR Implant System will be used to repair Zone 2 FDP tendon laceration (s). Open Achilles tendon repair surgery involves a long incision made in the back of the injured leg to expose the ruptured tendon. 12. Used for skin closure, minimally reactive, also used internally for vascular anastomoses, tendon/nerve repairs. tendon was repaired with a 6-strand technique, using a 4.0 Fiberloop for the core suture and 6.0 Prolene for the epitendinous suture. ... A tendon repair relies on balance between the strength of the suture used and the grip friction between the suture and the tendon. Current evidence advocates a multistrand repair using Ethibond. What Is the Best Method of Rehabilitation ... - Clinical Gate Prolene suture was tied to one limb of suture from the suture anchor and was used to pull the limb through the biceps anchor from inferior to superior. The average length of the rabbit PT tendon was 70 mm. In general, surgeons typically use either polypropylene or polydioxane sutures for fascia, depending on how strong the repair needs to be. Using a rabbit model, we compared polydioxanone tendon repairs with polypropylene tendon repairs. The traumatic rupture of tendons is a common clinical problem. barbed suture materials in tendon repair [5,6]. The addition of a circumferential suture may increase the strength of core repairs by 10% to 50%, reduce gapping between tendon ends, and smooth the repair site. Presently, there are three main techniques for treating these tears, including end-to-end primary repair, suture through bone tunnels, and repairs using suture anchors [5, 6]. Flexor tendon repair in zone II with 6-strand 8. - The resistance of a four- and eight-strand suture technique to gap formation during tensile testing: an experimental study of repaired canine flexor tendons after 10 days of in vivo healing. The risks of foreign implantation may be avoided in tendon repair by the use of absorbable sutures, for example polydioxanone. Absorbable vs Permanent Suture Suture Reactivity Strength Uses Size Prolene Minimal Moderate-High Skin Tendon 4-0 5-0 6-0 Nylon Minimal Moderate-High Skin Tendon 4-0 5-0 6-0 Silk Very Low XXXXX XXXXX •Reactivity Inflammation Scarring •Strength Holds wound together Although it might appear tedious, it can be quite comfortably done when one is using a loupe magnification. Ethilon (nylon), silk, Prolene (polypropylene) Lasts longer than 60 days. Achilles Tendon Repair Andrew J. Rosenbaum Andrew J. Elliott Martin J. O'Malley Open Repair Sterile Instruments/Equipment • Tourniquet • Number 2 FiberWire suture (Arthrex, Inc., Naples, FL) • 3-0 Prolene suture (Ethicon, Inc., Somerville, NJ) • 3-0 Vicryl suture (Ethicon, Inc., Somerville, NJ) • 4-0 Vicryl suture (Ethicon, Inc., Somerville, NJ) • 4-0 Ethilon suture… Participants: All patients with isolated flexor tendon injuries in zone 2 of the hand. Vessel graft sutures for AAA, Femoral-Popliteal graft, or Carotid Artery grafts. from the suture. The key developments in zone 2 repairs are (1) use of strong core suture, typically 4- or 6-strand repairs, (2) venting the critical annular … Suture material. Approximately four months after surgery, the patient developed a palmar collection at the 3-0 Silk. If a decision to repair has been made, then this should be with a nonresorbable suture, such as 6/0 Prolene. The ends of the tendon are then repositioned in an anatomically correct placement and sutured with a tough, non-absorbable suture. A running epitendinous suture was then placed around the circumference of the tendon with 6-0 Prolene. KEYWORDS Flexor tendon Repair methods Pulley release or venting Early active motion Secondary surgeries. flexor tendon repair. Regardless of … and Parikh et al. 2. Traditionally used for closure of subcutaneous tissues or injuries to the tongue or nailbed. Attempts to repair the tendon often have poor prognoses leading to lifelong consequences for patients requiring repeat interventions [3, 4]. Nylon™ (eg Ethilon) Natural. Core suture purchase ... Prolene, and Ticron sutures. Tension-free core suture repair was performed with a modified-Kessler, 4-strand repair using a double-stranded 4-0 Supramid suture. KEY POINTS Zone 2 flexor tendon repairs have evolved greatly over the past 3 decades. Silk. Copious irrigation was then performed. Procedure: Operative repair of Zone 2 FDP tendon lacerations. The long head of the biceps tendon was identified and followed cephalad to the intertubercle groove. Miyamoto et al.7 reported tendoscopic repair of the retinaculum for peroneal tendon subluxation or dislo-cation. The repair response of the tendon appears to be enhanced Tendon to tendon repair - if possible . Procedure: Operative repair of Zone 2 FDP tendon lacerations. Wrap the suture around the tendon, and reenter on the dorsal radial side of the tendon perpendicularly and 1-2 mm closer to the tendon end. Every repair (novel and control) was supplemented with a running, epitendinous 6-0 Prolene suture (Ethicon). Weave the suture through the lateral tendon margin. In children <5 years, a modified Kessler (Fig. These studies suggest that the tendon is a viable structure that possesses the intrinsic capacity for participating in the repair process. Tendons were surgically divided at the midpoint with a sharp blade. The purpose of this study was to assess adhesion formation with different suture techniques in an in vivo canine model. Abraham V-Y suture technique is recommended. The suture strength became progressively less important to the integrity of the repair and by 4 weeks the repair strength was approximately 167 N - eight times stronger than the original suture repair (Fig 4). ... suture anchor fixation, transosseous suture repair, and graft augmentation. Immobilization of the wrist in 20° of flexion was maintained for 2 weeks. sutures in each tendon end were loaded by hanging a weight for 10 seconds, and then the two tendon ends were connected using a two strand overhand knot plus 2 square knots (Figure 2). Bony avulsion - ORIF / button repair . Size 6-0 is appropriate for the face. Twelve patients with neglected Achilles tendon rupture underwent surgical repair using monofilament polypropylene mesh graft from 1999-2003. Flexor tendon repair suture material. However, they used only a single-row method. Repairing sutures for blood vessels. Evidence exists to encourage preserving and repairing the pulleys; as discussed earlier, they are essential for normal finger functioning (10,78,88-90). Vicryl (polygalactin 910), chromic gut) Degraded in tissue in less than 60 days. For size, our local plastic surgeon group recommends the largest suture that the tendon can tolerate to maximize retention strength. Interventions: All tendons were repaired with prolene suture using standard operative procedures. BIOMECHANICAL STUDY OF ABSORBABLE BARBED SUTURES IN FLEXOR TENDON REPAIRS 1,*Dai -Soon Kwak, 2Sung Gyun Jung, 3Moon Kyu Kim and 1Seung Ho Han ... strand conventional 3-0 PDS and 2-0 Prolene. barbed suture materials in tendon repair [5,6]. A circumferential suture with Prolene (Ethicon, Somerset, NJ, USA) is then placed in an interlocking horizontal mattress fashion (Fig. patellofemoral ligament repair. Repair is generally accomplished under regional or general anesthesia in a bloodless field. Prolene, which is biomechanically inferior to Ethibond [ ,]. Complete the repair with a simple running suture of 6/0 prolene; Release the tourniquet and secure haemostasis; Apply a padded plaster to relieve tension on suture lines and remove after 3 weeks in the upper limb and 6 weeks in the lower limb tendon was repaired with a 6-strand technique, using a 4.0 Fiberloop for the core suture and 6.0 Prolene for the epitendinous suture. Repair can be undertaken with different suturing techniques and using different materials. Plastic deformation of sutures creates an irreversible extension during load. 3-0 is a common size choice for extensor tendon repair of the hand where the tendons are thicker and can accommodate core sutures. Several authors have reported that the cruciate multistrand repair method and its variations most closely meet the criteria for the ideal tendon suture technique. 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 … Using a rabbit model, we compared polydioxanone tendon repairs with polypropylene tendon repairs. The average follow-up was 1.5 years. Non-Absorbable Braided. A novel technique for repair of chronic quadriceps tendon rupture. 1. They are indicated for use in abdominal wound closure, intestinal anastomosis, hernia repair, sternal closure and also for certain orthopedic procedures (cerclage or tendon repair). Active Comparator: Suture Repair. The same procedure was repeated for the second suture limb, passing it through the biceps anchor 1 mm posterior to the anterior border of the tendon. The following barbed suture materials have been used in experimental flexor tendon repair: Troccia et al. Prolene performed somewhat better, but still developed a significant amount of creep with a high failure rate. Data from two recent tendon repair studies in our laboratories suggest that the number of implanted cells may affect the repair biomechanics [2,36]. We expect that a tendon repair with 2-0 absorbable polydioxanone Quill barbed suture may be able to offer several advantages in flexor A 4-0 Prolene was used to repair this in a figure-of-eight fashion. Tang JB, Zhang Y, Cao Y, Xie RG. Nylon (Ethilon) and Prolene are both non-absorbable monofilament suture materials which provide good tensile strength with low tissue reactivity and are … hamstring autografts through a quadriceps tendon weave and transosseous patellar repair to address a failed quadriceps tendon repair. 3. Different materials used for tendon repair will have a different gliding resistance (GR) at the joint. All patients were placed in a non-weight and Parikh et al. Insufficient distal tendon - prepare bony insertion - modified Kessler into tendon - pass suture ends through distal phalanx and nail plate - tie over button - use 4.0 monofilament i.e. Indian J Plast Surg 2006:39:91–93. Traditionally used for skin closure. Troccia et al. 5-0, 6-0 Prolene or Gortex. Steel sutures are the most inert among all suture materials and provide maximum tensile strength. Prolene exhibited statistically larger (p< .05) relaxation and creep ratios than the other two sutures, and it was the only material to show temperature effects in creep and relaxation. Box sutures apposed cut ends of the tendon. In children <5 years, a modified Kessler (Fig. To test our hypothesis that such plastic deformation causes gap formation after tendon repair, we determined the plasticity of five different suture materials commonly used in tendon surgery. Likewise, Rehman and Kovacs2 described a novel repair technique in which they used a hamstring autograft with a prolene mesh and platelet-rich plasma. The tendon was repaired under loupe magnification (3.5×) with a 6-strand technique, using a 4.0 Fiberloop (Arthrex, Inc. Naples, FL) for the core suture and 6.0 running Prolene (Ethicon, Inc. Somerville, NJ) for the epitendinous suture . Previous studies have compared strength of repair and gliding resistance for various braided suture materials … Repair . Ethicon, Inc., Somerville, NJ) to identify the wound site at the time of sacrifice. A 23-gauge needle, which has a hole diameter of 0.4 mm, can easily accept a folded 4-0 or 5 0 prolene suture material which have a thickness of about Kamath BJ, Bhardwaj P. A technique for introducing looped sutures in techniques and early active mobilization. F l e x o r Tend o n In j u r i e s. Jin Bo Tang, MD. And here we see the pull-out button, which is a piece of felt and a button just like you would have on a shirt with a small blue suture, which is called PROLENE. These suture materials offer possible flexor tendon repair with reduction of bulk at the repair site and without redundant knot as po-tential weak point [5,7]. These results show that polydioxanone repairs were as strong as polypropylene during the first critical weeks of tendon healing. 3) suture with 4-0 Fiberwire (Arthrex, Naples, FL, USA) is performed, with a purchase length determined by tendon size. Biomechanical Testing. Quadriceps tendon repair using hamstring, prolene mesh and autologous conditioned plasma augmentation. Immediate splintage was done with thermoplastic splints and hand kept in dorsal blocking of 20 degrees flexion at wrist and 75 degrees at metacarpophalangeal joint. Monofilament synthetic sutures have the lowest rate of infection [2]. All patients were placed in a non-weight The nerve was repaired with a 10.0 nylon suture under microscope. Common uses for a non-absorbable suture would include vessel repair/anastomosis, bowel repair, tendon repair and skin closure (where the interrupted sutures would be later removed). Prolene, which is biomechanically inferior to Ethibond [ ,]. More Prolene Sutures sentence examples 10.4314/AAS.V18I1.4 Prolene mesh was fixed in the retrorectus space with prolene sutures, and tailored to cover the bare area of anterior surface of both recti muscles and fixed to the lateral flaps of the anterior rectus sheath with interrupted prolene sutures. Abraham V-Y suture technique is recommended. In our The response rate was 72%, with the most popular core suture being Prolene (64%) and the most popular technique being the Kessler repair (36%). The sutures made little contribution to the overall strength of a 4-week-old repair. Natural. In addition, 35 porcine hindlimb tendons were used to evaluate gap formation and the biomechanical behavior of the suture materials after tendon repair. If no string is felt, a woman should get to her physician as quickly as possible and use a back up contraceptive method to … Epitendinous repair usually is done with 5-0 or 6-0 monofilament suture (Prolene). The suture pull is parallel to the tendon collagen bundles, transmitting the stress of the repair directly to the opposing tendon ends. The weakest and unsuitable in most tendon repairs. Flexor tendon injuries still remain a challenging condition to manage to ensure optimal outcome for the patient. 3) suture with 4-0 Fiberwire (Arthrex, Naples, FL, USA) is performed, with a purchase length determined by tendon size. How do we report this procedure? Tendon grafts are cur- rently used to fill this deficit but are associated with potential complications relating to donor site morbidity and The ankle was placed in the cast in near neutral… Keywords: Achilles tendon repair, Modified Bunnell suture, Bundle-to-bundle suture, Achilles tendon rupture Background Although the Achilles tendon is the strongest tendon in the body, it is still prone to rupture [1]. Determining flexor-tendon repair techniques via soft computing ... in Column 1 for the use of the Lee repair technique using a 4-0 Ethilon with cross stitching of 0.5 cm from the core suture repair site is presented, as follows: L, 4-0, E, CS, 0.5. Four different loads were selected: 0 N, 5 N, 10 N and 15 N, for the The sutures are then tied using arthroscopic knot-tying techniques (Fig 7). 5-0, 6-0 Prolene or Gortex; Bowel repair sutures 3-0 Silk; Achilles tendon repair #5 Ethibond or Fiberwire; Braided Sutures vs. Non-braided or monofilament. looped suture tendon repair. The last two qualities to consider when choosing a suture is whether you would like the suture to be braided, and what type of needle that you would like to use. Is 26418 (Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon) the correct code here? e size of the core suture has an impact on tensile strength and work of exion of the repair, with sutures being stronger but causing more friction than or sutures [ ]. The tendon was separated from the muscle to its origin on the glenoid and released. Operative repair of Zone 2 FDP tendon lacerations will be performed using a 4-strand locked cruciate repair utilizing either 3.0 or 4.0 prolene suture. 1994, 19: 699–703. During that time, the suture itself and suture technique are the sole contributors to the strength of repair. The hypothesis being that the reclaimed FDS tendon autograft will redistribute tensile forces away from the FDP repair site, increasing overall strength and resistance to gapping in Zone II flexor tendon injuries compared with the current clinical techniques. Fibrewire and stainless-steel sutures and repairs were significantly stronger and stiffer than the other suture types. Active Comparator: Suture Repair. prolene - need to remove button and sutures at 8/52 . published their research data in 2009, where they used a 2-0 barbed bidirectional non-absorbable polypropylene suture (Quill™) for flexor tendon repair. The CoNextions TR Implant System will be used to repair Zone 2 FDP tendon laceration (s). The repair site is vascularized by proliferation of vascular channels from within the proximal end of the tendon ( 18 ). e balance between tensile strength and work of exion therefore remains a choice for the surgeon. M. Wong, S. J. Sebastin and B. H. Lim A simple technique of making a looped suture for flexor tendon repair. autogenous grafts and/or tendon transfers for neglected Achilles tendon rupture. After these were repaired, the cut ends of the forearm fascia were approximated over the most proximal aspect of the wound." Rabbit tendons were defrosted to room temperature and kept moist throughout the experiment. a) Central cut wound of the volar aspect of right wrist at tendon zone 5, b) Exploration of the wound and complete the examination under general anesthesia was done, c) Identification of distal and proximal tendon ends, d) Repair of tendons by modified Kessler repair with 4 core sutures with prolene 4/0, e-f) Median nerve repair with prolene 7/0. 2). RESEARCH ARTICLE The effect of modified locking methods and suture materials on Zone II flexor tendon repair—An ex vivo study Susumu Yoneda ID 1,2*, Hirotaka Okubo2, Stephen W. Linderman ID 1, Nozomu Kusano3, Matthew J. Silva1, Stavros Thomopoulos4,5, Fuminori Kanaya2, Richard H. Gelberman1 1 Department of Orthopaedic Surgery, Washington University, … The results for Prolene and Ethibond were similar in the tendon repair groups with respect to gap and ultimate forces although Ethibond provided significantly increased repair … We reviewed 39 of 47 patients (83%) with 40 … Old injury, Achilles tendon ruptured for more than 3 weeks; at this time, Achilles tendon contracture always exceeds 6 cm. To date, there is no final consensus about the ideal suture material in flexor tendon repair but it has been demonstrated that the suture material should have high tensile strength, prevent gapping, should be easy to use and be biocompatible [ 3 ], [ 4 ]. Prolene, Polydioxanone (PDS), Ethibond, Vicryl, and FiberWire sutures were biomechanically … Tendon repair is surgically challenging because the tendon often retracts, resulting in a gap between the torn end and its bony insertion. In our ... the needle of the 4-0 prolene suture is cut at its junction. Prolene had a low offset yield strength and high initial extensions at 30, 60, and 90N combined with relatively large creep, relaxed elongation, and peak-to-peak displacement. In addition, 35 porcine hindlimb tendons were used to evaluate gap formation and the biomechanical behavior of the suture materials after tendon repair. 1. Different materials used for tendon repair will have a different gliding resistance (GR) at the joint. Methods: From 1 January 2000 to 31 December 2003, the pDI suture was performed in 61 patients with 62 Achilles tendon ruptures. Discussion. A non-absorbable suture is best when prolonged tension (fascial closure, tendon repair, bone anchoring, or ligament repair) is required for suitable healing to take place. Access Options Institutional Login Techniques in Orthopaedics Prolene™ (Polypropylene) Synthetic. J Hand Surg 2006;31A:987–992. Twelve patients with neglected Achilles tendon rupture underwent surgical repair using monofilament polypropylene mesh graft from 1999-2003. Although stainless steel is the strongest material that can be used at the time of repair, it has serious disadvantages. Flexor Tendon Repair. In arthroscopic rotator cuff repair surgery, a double-row suture bridge results in a significantly higher tendon healing rate than a single-row repair.8 The And we use this PROLENE because it's very smooth on the outside and will glide. J Hand Surg Br. Immobilization of the wrist in 20° of flexion was maintained for 2 weeks. Absorbable (e.g. Achilles tendon repair. Suture Configurations Flexor Tendon repair types: Simple sutures: The suture pull is parallel to the tendon collagen bundles, transmitting the stress of the repair directly to the opposing tendon ends. Methods: Two novel FDP repair methods utilizing portions … Five strands, each of … The risks of foreign implantation may be avoided in tendon repair by the use of absorbable sutures, for example polydioxanone. e balance between tensile strength and work of exion therefore remains a choice for the surgeon. The weakest and unsuitable in most tendon repairs. In the first ... polypropylene sutures (Prolene 5-0. This repair is commonly performed clinically (Williams and Amis 1995, Diao et al. In this surgical method no.1 prolene was threaded through the proximal tendon and the same suture material passed through the distal tendon and its bilateral ends were tightened over the rubber button either under the heel or by the sides of the heel. Tendon suturing techniques. Subsequently, and finally, a running suture (Prolene 6-0) was applied (Figure 1). Prolene had a low offset yield strength and high initial extensions at 30, 60, and 90 N combined with relatively large creep, relaxed elongation, and peak-to-peak displacement. In this study, the in vivo tensile strength half-life of 4/0 polydioxanone was found to be approximately 4 weeks. It was whip-stitched with 5–0 prolene to produce a traction suture. Prolene exhibited statistically larger (p< .05) relaxation and creep ratios than the other two sutures, and it was the only material to show temperature effects in creep and relaxation. In this study, the in vivo tensile strength half-life of 4/0 polydioxanone was found to be approximately 4 weeks. Old injury, Achilles tendon ruptured for more than 3 weeks; at this time, Achilles tendon contracture always exceeds 6 cm. There was no significant difference between polydioxanone and polypropylene repairs at any stage. Many repair techniques have been developed to increase the suture strength after tendon repair surgery. Fibrewire and stainless-steel sutures and repairs were significantly stronger and stiffer than the other suture types. Place a single suture into the cut end core of the tendon, entering about one third of the diameter of the tendon. The results for Prolene and Ethibond were similar in the tendon repair groups with respect to gap and ultimate forces although Ethibond provided significantly increased repair … Epitendinous repair usually is done with 5-0 or 6-0 monofilament suture (Prolene). protocol. Approximately four months after surgery, the patient developed a palmar collection at the Background: The percutaneous technique for Achilles tendon repair with the Dresden instruments (pDI suture) was developed to minimize the typical problems of percutaneous Achilles tendon sutures. These suture materials offer possible flexor tendon repair with reduction of bulk at the repair site and without redundant knot as po-tential weak point [5,7]. We used an 18-gauge needle and PROLENE suture to precisely place mattress sutures in the tendon. 1996). FDP) repair site without the use of core sutures. e size of the core suture has an impact on tensile strength and work of exion of the repair, with sutures being stronger but causing more friction than or sutures [ ]. Conclusions: Suture material strongly influences the biomechanical performance of multistrand tendon repairs and is an important consideration for the surgeon. Fibrewire and stainless steel are the most biomechanically suitable suture materials for flexor tendon repair whereas nylon is the least suitable.
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