In Vitro Biomechanical Study on the 'Figure-of-Eight' and Kessler Sutures in Swine Flexor Tendons

Abstract Objective To evaluate the biomechanical properties of the “figure-of-eight” and Kessler suture techniques for tendons. Methods Flexor tendons of porcine fingers were divided into two groups with triple central “figure of eight” sutures (six passages) and Kessler sutures (two passages) associated with simple and continuous peripheral sutures, and submitted to continuous longitudinal mechanical tests, to obtain the mechanical properties of maximum load and energy at maximum load. Results The mean maximum load and energy at maximum load in the “figure-of-8” suture were of 63.4 N and 217.3 N.mm respectively; in the Kessler suture, the values were of 34.19 N and 100.9 N.mm respectively. The statistical analysis indicated that the “figure-of-eight” suture is mechanically superior to the Kessler technique. Conclusion Under the conditions of this experiment and in the flexor tendon of porcine fingers, the triple “figure-of-eight” suture (six passages) is more resistant than the Kessler suture (two passages). The “figure-of-eight” suture with six passages enables active movement in the immediate rehabilitation of the flexor tendon repair of the finger, with little risk of rupture or suture spacing.