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Updated: Jan 13, 2026
Using Q Suture to Enhance Resistance to Gap Formation and Tensile Strength of Repaired Flexor Tendons
Published on: June 3, 2020
Effects of Cyclic Tension on the Biomechanical Properties of a New Eight-strand Suture for Flexor Tendon Repair
Keisuke Ishizaka1, Koji Moriya1, Takuma Kuroda1
1From the Niigata Hand Surgery Foundation, Niigata, Japan.
Background:
We developed a new, simple 8-strand suture technique, termed the Yoshizu cross-lock repair. The technique allows sufficient tensile strength to counter the 2-mm gap formation force based on static analyses with a linear loading test, which does not consider cycling conditions during repetitive passive or light active motion activities.
Methods:
Twelve porcine flexor tendons were transected and repaired using the Yoshizu cross-lock system; no peripheral sutures were placed. The repaired tendons were subjected to a cyclic loading test. The number of tendons that formed a 2-mm gap at the repair site during 20 cycles was determined. The resistance at the first and 20th loading cycles, the gap distance between the 2 tendon ends after cyclic loading, and the ultimate breaking strengths were recorded.
Results:
No tendons repaired with the Yoshizu cross-lock repair formed a 2-mm gap during the 20 cycles of the cyclic loading test. The mean resistance was 3.9 ± 0.2 Newtons (N)/mm during the first cycle, and 6.1 ± 0.2 N/mm during the 20th cycle. The mean gap at the repair site after cyclic loading was 0.56 ± 0.62 mm, and the mean ultimate strength was 73.9 ± 6.8 N.
Conclusions:
This study suggested that the Yoshizu cross-lock repair has sufficient tensile strength based on a cyclic loading test. This suture technique is reliable and can be used with confidence for flexor tendon repair, which requires early active mobilization.
