Advertisement
Original Communications| Volume 25, ISSUE 2, P260-269, March 2000

An in vivo study of locking and grasping techniques using a passive mobilization protocol in experimental animals

      Abstract

      An in vivo experimental study was performed on the flexor profundus tendons of adult canines to determine tensile strength differences between locking and grasping technique repairs and to document the tensile strength using a passive mobilization protocol through the first 21 days following surgery. Forty experimental third and fourth flexor tendons of the right forepaws were lacerated and repaired with either of the 2 techniques. The experimental tendons were harvested at days 3, 7, 14, and 21 and were biomechanically tested. The third and fourth profundus tendons of the left forepaws were used as control (day 0) tendons; they were lacerated and repaired with the locking or grasping techniques at the time of harvest and also were biomechanically tested. The locking technique statistically improved tensile strength values at days 0, 3, and 21. The tensile strength decrease was minimal when using a passive mobilization protocol after surgery. (J Hand Surg 2000:25A:260–269. Copyright © 2000 by the American Society for Surgery of the Hand).

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Hand Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Small JO
        • Brennen MD
        • Colville J.
        Early active mobilisation following flexor tendon repair in zone 2.
        J Hand Surg. 1989; 14B: 383-391
        • Cullen KW
        • Tolhurst P
        • Lang D
        • Page RE.
        Flexor tendon repair in zone 2 followed by controlled active mobilisation.
        J Hand Surg. 1989; 14B: 392-395
        • Savage R
        • Risitano G.
        Flexor tendon repair using a “six strand” method of repair and early active mobilisation.
        J Hand Surg. 1989; 14B: 396-399
        • Lee H.
        Double loop locking suture: a technique of tendon repair for early active mobilization. Part II: clinical experience.
        J Hand Surg. 1990; 15A: 953-958
        • Bainbridge LC
        • Robertson C
        • Gillies D
        • Elliot D.
        A comparison of post-operative mobilization of flexor tendon repairs with “passive flexion—active extension” and “controlled active motion” techniques.
        J Hand Surg. 1994; 19B: 517-521
        • Elliot D
        • Moiemen NS
        • Flemming AFS
        • Harris SB
        • Foster AJ.
        The rupture rate of acute flexor tendon repairs mobilized by the controlled active motion regimen.
        J Hand Surg. 1994; 19B: 607-612
        • Savage R.
        In vitro studies of a new method of flexor tendon repair.
        J Hand Surg. 1985; 10B: 135-141
        • Lin G-T
        • An K-N
        • Amadio PC
        • Cooney III., WP
        Biomechanical studies of running suture for flexor tendon repair in dogs.
        J Hand Surg. 1988; 13A: 553-558
        • Lee H.
        Double loop locking suture: a technique of tendon repair for early active mobilization. Part I: evolution of technique and experimental study.
        J Hand Surg. 1990; 15A: 945-952
        • Robertson GA
        • Al-Qattan MM.
        A biomechanical analysis of a new interlock suture technique for flexor tendon repair.
        J Hand Surg. 1992; 17B: 92-93
        • Aoki M
        • Pruitt DL
        • Kubota H
        • Manske PR.
        Effect of suture knots on tensile strength of repaired canine flexor tendons.
        J Hand Surg. 1995; 20B: 72-75
        • Kubota H
        • Aoki M
        • Pruitt DL
        • Manske PR.
        Mechanical properties of various circumferential tendon suture techniques.
        J Hand Surg. 1996; 21B: 474-480
        • Shaieb MD
        • Singer DI.
        Tensile strengths of various suture techniques.
        J Hand Surg. 1997; 22B: 764-767
        • Hotokezaka S
        • Manske PR.
        Differences between locking loops and grasping loops: effects on 2-strand core suture.
        J Hand Surg. 1997; 22A: 995-1003
        • Mashadi ZB
        • Amis AA.
        The effect of locking loops on the strength of tendon repair.
        J Hand Surg. 1991; 16B: 35-39
        • Mason ML
        • Allen HS.
        The rate of healing of tendons: an experimental study of tensile strength.
        Ann Surg. 1941; 113: 424-459
        • Urbaniak JR
        • Cahill Jr, JD
        • Mortenson RA.
        Tendon suturing methods: analysis of tensile strength.
        in: AAOS symposium on tendon surgery in the hand. : CV Mosby, St Louis1975: 70-80
        • Hitchcock TF
        • Light TR
        • Bunch WH
        • et al.
        The effect of immediate constrained digital motion on the strength of flexor tendon repairs in chickens.
        J Hand Surg. 1987; 12A: 590-595
        • Aoki M
        • Kubota H
        • Pruitt DL
        • Manske PR.
        Biomechanical and histologic characteristics of canine flexor tendon repair using early postoperative mobilization.
        J Hand Surg. 1997; 22A: 107-114
        • Feehan LM
        • Beauchene JG.
        Early tensile properties of healing chicken flexor tendons: early controlled passive motion versus postoperative immobilization.
        J Hand Surg. 1990; 15A: 63-68
        • Gelberman RH
        • Woo SL-Y
        • Lothringer K
        • Akeson WH
        • Amiel D.
        Effects of early intermittent passive mobilization on healing canine flexor tendons.
        J Hand Surg. 1982; 7: 170-175
        • Winters SC
        • Gelberman RH
        • Woo SL-Y
        • Chan SS
        • Grewal R
        • Seiler III., JG
        The effects of multiple-strand suture methods on the strength and excursion of repaired intrasynovial flexor tendons: a biomechanical study in dogs.
        J Hand Surg. 1998; 23A: 97-104
        • Zar JH.
        Biostatistical analysis.
        in: 4th ed. : Prentice-Hall, Upper Saddle River, NJ1999: 231-272
        • Pennington DG.
        The locking loop tendon suture.
        Plast Reconstr Surg. 1979; 63: 648-652
        • Hatanaka H
        • Manske PR.
        Effect of the cross-sectional area of locking loops in flexor tendon repair.
        J Hand Surg. 1999; 24A: 751-760
        • Lindsay WK
        • Thomson HG
        • Walker FG.
        Digital flexor tendons: an experimental study: Part II. The significance of a gap occurring at the line of suture.
        Br J Plast Surg. 1960; 13: 1-9
        • Seradge H.
        Elongation of the repair configuration following flexor tendon repair.
        J Hand Surg. 1983; 8: 182-185
        • Becker H
        • Davidoff M.
        Eliminating the gap in flexor tendon surgery: a new method of sutuzre.
        Hand. 1977; 9: 306-311
        • Ketchum LD.
        Suture materials and suture techniques used in tendon repair.
        Hand Clin. 1985; 1: 43-53
        • Adar A
        • Irstam L.
        Elongation in profundus tendon repair: a clinical and radiological study.
        Scand J Plast Reconstr Surg. 1981; 15: 61-68
        • Silfverskiöld KL
        • May EJ
        • T|$$|Adornvall AH.
        Gap formation during controlled motion after flexor tendon repair in zone II: a prospective clinical study.
        J Hand Surg. 1992; 17A: 539-546
        • Greenwald DP
        • Randolph MA
        • Hong H-Z
        • May Jr., JW
        Augmented Becker versus modified Kessler tenorrhaphy in monkeys: dynamic mechanical analysis.
        J Hand Surg. 1995; 20A: 267-272
        • Aoki M
        • Ito K
        • Wada T
        • Ooyama N.
        Mechanical characteristics of cross-stitch epitenon suture in association with various two-strand core sutures: a biomechanical study using canine cadaver tendons.
        Injury. 1996; 27: 703-707
        • Diao E
        • Hariharan JS
        • Soejima O
        • Lotz JC.
        Effect of peripheral suture depth on strength of tendon repairs.
        J Hand Surg. 1996; 21A: 234-239
        • Zatiti SCA
        • Mazzer N
        • Barbieri CH.
        Mechanical strengths of tendon sutures: an in vitro comparative study of six techniques.
        J Hand Surg. 1998; 23B: 228-233
        • Thurman RT
        • Trumble TE
        • Hanel DP
        • Tencer AF
        • Kiser PK.
        Two-, four-, and six-strand zone II flexor tendon repairs: an in situ biomechanical comparison using a cadaver model.
        J Hand Surg. 1998; 23A: 261-265
        • Stein T
        • Ali A
        • Hamman J
        • Mass DP.
        A randomized biomechanical study of zone II human flexor tendon repairs analyzed in an in vitro model.
        J Hand Surg. 1998; 23A: 1046-1051
        • Pruitt DL
        • Aoki M
        • Manske PR.
        Effect of suture knot location on tensile strength after flexor tendon repair.
        J Hand Surg. 1996; 21A: 969-973
        • Kubota H
        • Manske PR
        • Aoki M
        • Pruitt DL
        • Larson BJ.
        Effect of motion and tension on injured flexor tendons in chickens.
        J Hand Surg. 1996; 21A: 456-463
        • Halikis MN
        • Manske PR
        • Kubota H
        • Aoki M.
        Effect of immobilization, immediate mobilization, and delayed mobilization on the resistance to digital flexion using a tendon injury model.
        J Hand Surg. 1997; 22A: 464-472