In vitro biomechanical evaluation of the double loop suture for flexor tendon repair

Fifty-one fresh frozen human anatomic specimen flexor superficialis and pro fundus tendons that had been transected completely were repaired using the double loop, the single loop, and the modified Kessler techniques, and the resistances to mechanical distraction at 1, 2, and 3 mm and the ultimate lo ad to Failure were compared. The mechanical distraction at 1, 2, and 3 mm c reated nearly identical gaps at the tendon repair sites. There was no signi ficant difference among the three repair techniques to resisting distractio n at 1 and 2 mm, However, the double loop technique presented a mean resist ance force of 22.0 N to distraction at 3 mm and 45.8 N in load to failure, which was significantly greater than the single loop (18.8 N at 3 mm distra ction and 31.5 N failure load) and the modified Kessler (19.0 N at 3 mm dis traction and 26.0 N failure load). This suggests the double loop technique may be superior to the single loop and the modified Kessler techniques in r esisting gap in the range of forces generated in the early rehabilitation p rotocol.