A Biomechanical Comparison Between Asymmetric Pennington Technique and Conventional Core Suture Techniques: 6-Strand Flexor Tendon Repair

naoya kozono, Takamitsu Okada, Naohide Takeuchi, Takeshi Shimoto, Hidehiko Higaki, Yasuharu Nakashima

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose To evaluate the fatigue strength and gap sizes of the asymmetric Pennington technique compared with 2 conventional 6-strand core suture techniques: the triple-looped suture and the Yoshizu #1. Methods We recorded the fatigue strength (forces × cycles) and gap sizes of a 6-strand flexor tendon repair with different core suture techniques under cyclic loading in 30 porcine tendons. The asymmetric Pennington technique was performed with a Pennington repair of equal suture purchase in the 2 tendon stumps, with the 2 other Pennington repairs shifted by 3 mm, respectively, along the longitudinal axis of the tendon in relation to the first Pennington repair. The triple-looped suture technique was made with triple Tsuge sutures. The Yoshizu #1 technique was performed with a combined Pennington repair (using a double strand) and Tsuge suture. Results The asymmetric Pennington technique showed significantly greater fatigue strength and significantly smaller gaps in comparison to the triple-looped suture and Yoshizu #1 techniques. Conclusions This study demonstrated that the asymmetric Pennington technique generated increased fatigue strength and reduced gap sizes compared with 2 conventional 6-strand core suture techniques, the triple-looped suture and Yoshizu #1. Clinical relevance The asymmetric Pennington technique may permit an early active motion rehabilitation protocol similar to the triple-looped suture and Yoshizu #1 techniques.

Original languageEnglish
Pages (from-to)79.e1-79.e8
JournalJournal of Hand Surgery
Volume43
Issue number1
DOIs
Publication statusPublished - Jan 1 2018

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Suture Techniques
Tendons
Sutures
Fatigue
Swine
Rehabilitation

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

A Biomechanical Comparison Between Asymmetric Pennington Technique and Conventional Core Suture Techniques : 6-Strand Flexor Tendon Repair. / kozono, naoya; Okada, Takamitsu; Takeuchi, Naohide; Shimoto, Takeshi; Higaki, Hidehiko; Nakashima, Yasuharu.

In: Journal of Hand Surgery, Vol. 43, No. 1, 01.01.2018, p. 79.e1-79.e8.

Research output: Contribution to journalArticle

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AU - Shimoto, Takeshi

AU - Higaki, Hidehiko

AU - Nakashima, Yasuharu

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N2 - Purpose To evaluate the fatigue strength and gap sizes of the asymmetric Pennington technique compared with 2 conventional 6-strand core suture techniques: the triple-looped suture and the Yoshizu #1. Methods We recorded the fatigue strength (forces × cycles) and gap sizes of a 6-strand flexor tendon repair with different core suture techniques under cyclic loading in 30 porcine tendons. The asymmetric Pennington technique was performed with a Pennington repair of equal suture purchase in the 2 tendon stumps, with the 2 other Pennington repairs shifted by 3 mm, respectively, along the longitudinal axis of the tendon in relation to the first Pennington repair. The triple-looped suture technique was made with triple Tsuge sutures. The Yoshizu #1 technique was performed with a combined Pennington repair (using a double strand) and Tsuge suture. Results The asymmetric Pennington technique showed significantly greater fatigue strength and significantly smaller gaps in comparison to the triple-looped suture and Yoshizu #1 techniques. Conclusions This study demonstrated that the asymmetric Pennington technique generated increased fatigue strength and reduced gap sizes compared with 2 conventional 6-strand core suture techniques, the triple-looped suture and Yoshizu #1. Clinical relevance The asymmetric Pennington technique may permit an early active motion rehabilitation protocol similar to the triple-looped suture and Yoshizu #1 techniques.

AB - Purpose To evaluate the fatigue strength and gap sizes of the asymmetric Pennington technique compared with 2 conventional 6-strand core suture techniques: the triple-looped suture and the Yoshizu #1. Methods We recorded the fatigue strength (forces × cycles) and gap sizes of a 6-strand flexor tendon repair with different core suture techniques under cyclic loading in 30 porcine tendons. The asymmetric Pennington technique was performed with a Pennington repair of equal suture purchase in the 2 tendon stumps, with the 2 other Pennington repairs shifted by 3 mm, respectively, along the longitudinal axis of the tendon in relation to the first Pennington repair. The triple-looped suture technique was made with triple Tsuge sutures. The Yoshizu #1 technique was performed with a combined Pennington repair (using a double strand) and Tsuge suture. Results The asymmetric Pennington technique showed significantly greater fatigue strength and significantly smaller gaps in comparison to the triple-looped suture and Yoshizu #1 techniques. Conclusions This study demonstrated that the asymmetric Pennington technique generated increased fatigue strength and reduced gap sizes compared with 2 conventional 6-strand core suture techniques, the triple-looped suture and Yoshizu #1. Clinical relevance The asymmetric Pennington technique may permit an early active motion rehabilitation protocol similar to the triple-looped suture and Yoshizu #1 techniques.

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