Tensile strength of modified 4-strand cruciate technique for transversely or obliquely lacerated tendons

Abstract

Purposes: To assess the tensile strength of the modified 4-strand cruciate technique for obliquely lacerated tendons, and to compare the findings with the strength of transversely lacerated tendons repaired at various grasping depths.

Methods: 60 porcine front foot tendons were evenly divided into 4 groups. In groups 1 to 3, tendons were transversely lacerated and repaired with grasping points at both ends away from the laceration by 5 mm, 10 mm, and 15 mm respectively. In group 4, tendons were obliquely lacerated and repaired with a grasping point 5 mm away from the laceration on one end and 15 mm on the other. All tendons were repaired with a modified 4-strand core suture and continuous epitendinous suture, and then tested to failure in a tensile machine.

Results: The tensile strength in group 1 was significantly lower than that in the other 3 groups (p<0.005). The tensile strength in group 4 was not significantly different from groups 2 and 3.

Conclusion: The tensile strength of modified 4-strand cruciate repair configuration is not weakened in obliquely lacerated tendons; the grasping point at one end of the tendon being 15 mm away from laceration provides sufficient strength to compensate for the relatively weak 5-mm end. So long as one grasping point is away from the laceration site by 10 mm, the ultimate tensile strength of the transversely lacerated tendons appears acceptable. The modified 4-strand cruciate repair is safe to use for repairing obliquely lacerated tendons.