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Updated: Feb 22, 2026
Using Q Suture to Enhance Resistance to Gap Formation and Tensile Strength of Repaired Flexor Tendons
Published on: June 3, 2020
Cyclic Testing of the 6-Strand Tang and Modified Lim-Tsai Flexor Tendon Repair Techniques
Gavrielle Hui-Ying Kang1, Yoke-Rung Wong2, Rebecca Qian-Ru Lim1
1Department of Hand Surgery, Singapore General Hospital, Singapore.
Purpose:
In this study, we compared the Tang repair technique with the 6-strand modified Lim-Tsai repair technique under cyclic testing conditions.
Methods:
Twenty fresh-frozen porcine flexor tendons were randomized into 2 groups for repair with either the modified Lim-Tsai or the Tang technique using Supramid 4-0 core sutures and Ethilon 6-0 epitendinous running suture. The repaired tendons were subjected to 2 stage cyclic loading. The survival rate and gap formation at the repair site were recorded.
Results:
Tendons repaired by the Tang technique achieved an 80% survival rate. None of the modified Lim-Tsai repairs survived. The mean gap formed at the end of 1000 cycles was 1.09 mm in the Tang repairs compared with 4.15 mm in the modified Lim-Tsai repairs.
Conclusions:
The Tang repair is biomechanically stronger than the modified Lim-Tsai repair under cyclic loading.
Clinical Relevance:
The Tang repair technique may exhibit a higher tolerance for active mobilization after surgery with less propensity for gap formation.
