EFFECT OF PERIPHERAL SUTURE DEPTH ON STRENGTH OF TENDON REPAIRS

The peripheral suture in flexor tendon repairs was originally introduc ed to ''tidy up'' the repair site and to improve gliding after core su ture placement. More recently, it has been proposed that the periphera l suture can be an important structural component of tendon repair; ye t, the effect of peripheral suture technique as an independent factor on the strength of the tendon repair has had little attention. We proc eeded to determine whether differing levels of penetration of the tend on by the peripheral suture significantly affect the strength of the r epair. We performed tensile tests on two groups of fresh frozen cadave r flexor digitorum superficialis tendons that had lacerations repaired by modified Kessler core sutures: one group had supplemental superfic ial peripheral sutures while the other group had supplemental deep (ha lf the depth to the center of the tendon) peripheral sutures. The mean failure load of the deep peripheral suture group (38.96 N) was almost 80% greater than that of the superficial suture group (21.68 N). This increased strength may be due to an improved tendonsuture interface, with the deep peripheral suture acting as an auxiliary core suture. Ou r results with deep peripheral sutures, a simple technique based on a modification of commonly employed suture patterns, demonstrate substan tially improved repair strength. This suture has the potential to be u sed in conjunction with early active finger motion rehabilitation prog ram after flexor tendon repair.