Biomechanical Comparative Study Of Different Suture Methods For 45-Degree Oblique Injury Of Flexor Tendon

Objective The aim of our study is to compare the biomechanical strength of different suturing methods for 45-degree oblique injury of flexor tendon.Methods A total of 56 deep flexor tendons of the hind hoof from pigs were randomly divided into7 groups according to the cutting direction and suturing method.The groups are as follows: Group A: transverse injury with modified Kessler method conventional suturing.Group B: oblique injury with modified Kessler method conventional suturing(short side 7mm).Group C: oblique injury with modified Kessler method conventional suture(long side 7mm).Group D: oblique injury with modified Kessler method oblique suture.Group E: oblique injury with Kleinert method oblique suture.Group F: oblique injury with double-line modified Kessler method oblique suture.Group G: oblique injury with Cruciate method oblique suture.The suturing time of each tendon is recorded,and 2 mm gap tensile strength,fractured of tensile strength after suturing is measured separately.Statistical analysis was performed with ANOVA.Results(1)When the modified Kessler method was used for suture,the biomechanical strength of oblique injured tendon(long side 7mm)was significantly lower than that of transverse injured tendon.(2)When repairing oblique injured tendons,the biomechanical strength of the double-line modified Kessler method and Cruciate method was significantly higher than that of the modified Kessler method.Moreover,the double line modified Kessler method needs more time than that of cruciate method,modified Kessler method and Kleinert method(P<0.05).Conclusion(1)The biomechanical characteristics of the tendon with oblique injury are different from those of the transverse injury tendon.It should be ensured that the short-sided needle distance is more than 7 mm when the tendon is sutured with oblique injury.(2)The Cruciate method oblique suture is a simple operation and firm suturing method of oblique injury tendon suture,which is worthy of clinical promotion and application.