Cross stitch peripheral tendon repair: a mechanical comparison with core stitch techniques
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Updated: Oct 15, 2026

Using Q Suture to Enhance Resistance to Gap Formation and Tensile Strength of Repaired Flexor Tendons
Published on: June 3, 2020
M Y Papaloïzos1, N Schärer, S Rehart
1Division of Hand, Plastic and Reconstructive Surgery, Zurich University Hospital, Switzerland. michael.papaloizos@hcuge.ch
Abstract:
The purpose of this experimental study was to compare certain mechanical properties of a true epitendineal cross stitch suture with simple and double locking core tendon repairs. Using tensile strength and tendon lengthening until gap formation as measurement parameters, these three types of repair were tested in human flexor and extensor tendons from fresh cadavers. The peripheral cross stitch and the locked core repairs were found to have a greater lengthening capacity than the simple core suture, whereas the latter significantly better withstood axial load. Our findings established that, at least when used as a true epitendinous suture, the cross stitch technique alone was not suited for the repair of severed tendons. However, its design is particularly useful in preventing the suture site from potentially restrictive bulking.

