A technique for introducing looped sutures in flexor tendon repair

ABSTRACT

Stronger flexor tendon repairs facilitate early active motion therapy protocols. Core sutures using looped suture material provide 1 ½ to twice the strength of Kessler′s technique (with four strand and six strand Tsuge technique respectively). The technique is well-described and uses preformed looped sutures (supramid). This is not available in many countries and we describe a technique whereby looped sutures can be introduced in flexor tendon repair by the use of 23 G hypodermic needle and conventional 4.0 or 5.0 sutures. This is an alternative when the custom made preformed sutures are not available. This can be practiced in zone 3 to zone 5 repairs. Technical difficulties limit its use in zone 2 repairs.

KEY WORDS

Flexor tendon repair - modified looped suture

• 1 Tsuge K, Ikuta Y, Matsuishi Y. Intra-tendinous tendon suture in the hand: A new technique. The Hand. 1975; 7: 250-5
• 2 Lim BH, Tsai TM. The six-strand technique for flexor tendon repair. Atlas Hand Clin 1996; 1: 65-76
• 3 Labana N, Messer T, Lautenschlager E, Nagda S, Nagle D. A Biomechanical analysis of the modified Tsuge suture technique for repair of flexor tendon lacerations. J Hand Surg 2001; 26B: 297-300
• 4 Ethicon-Product catalogue: Size and diameter of Sutures. 5