Purpose
The Q suture has been reported to be an effective alternative to conventional peripheral
sutures in tendon repair. Whether the Q method can be used as a core suture rather
than a peripheral suture by adjusting the purchase length is unknown. We tested a
double Q suture technique with variable purchase length and studied its effects on
gap formation and tensile strength using an ex vivo model.
Methods
Forty pig flexor tendons were repaired using the double Q sutures with purchase lengths
of 2, 4, 6, and 8 mm. Twenty tendons repaired using the double Tsuge and double Kessler
sutures with an 8-mm purchase length were used as controls. The tendons were subjected
to cyclic loading and load-to-failure. The number of tendons that formed an initial
or 2-mm gap between the tendon ends, gap distance at the repair site, stiffness, and
ultimate strength were recorded.
Results
During cyclic loading, the double Q suture with a 4–8-mm purchase had fewer tendons
form an initial or 2-mm gap and a smaller gap size at the repair site than the Tsuge
and Kessler sutures. The stiffness of the double Q suture with a 6–8-mm purchase length
and Tsuge suture was greater than those of the double Kessler suture. The double Q
suture with a 2-mm purchase length had smaller ultimate strength than the other sutures.
Conclusions
The Q suture may be an effective tendon repair method whose role can be converted
between peripheral and core sutures via adjusting the suture purchase length. With
an optimal suture length of 4–6 mm, the double Q method had tensile resistance superior
to 4-strand core sutures.
Clinical relevance
The double Q suture may be a viable option as a core suture in flexor tendon repair
when the purchase length is appropriately adjusted.
Key words
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Article Info
Publication History
Published online: September 27, 2022
Accepted:
August 3,
2022
Received:
January 13,
2022
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
