Mechanical properties of various circumferential tendon suture techniques

We evaluated the mechanical properties of six different circumferential tendon sutures with a variable number of suture strands. Seventy-two human cadaver flexor profundus tendons were cut and repaired using only a 6/0 polypropylene circumferential suture. The six running suture techniques were: Simple; Simple-locking; Lembert; Halsted; Cross-stitch; Lin-locking; using 10, 14 and 18 suture passes. The increased suture passes increased both tensile and gap strengths. The tensile strength of the Lin-locking technique (29 to 63 N) was significantly stronger than the others, followed by Cross-stitch (27 to 38 N), Halsted (21 to 27N), Lembert (20 to 27N), Simple (11 to 22 N) and Simple-locking (10 to 17 N). The gap strength values were between 3 to 14N, with no significant differences between the techniques. The resistance to gliding, as measured by work of flexion, was not affected by the number of strands. However, the Lin-locking significantly increased the resistance to gliding (33-36%) compared to the other techniques (6-21%); there were no significant differences between these five techniques.