Fig 1.
Overview of suture techniques used.
The different techniques Pulvertaft (PT), Fridén (FR) and Woven-Fridén (WF) are illustrated: The donor tendon (above) was woven through incisions in the recipient tendon (below). For each suture technique the same amount of connection points between the tendons was used. The threads were cut in standardized fashion at 10 mm length.
Fig 2.
Schematic model of the Woven-Fridén tenorrhaphy (WF) (30 mm tendon-tendon overlap) using brown and white strings.
1. Mark incisions and overlap for donor- (brown) and recipient tendon (white) with a surgical pen and make three incisions in the recipient tendon using a No. 15 scalpel blade. 2. Interlace the donor tendon (brown) through the recipient tendon (white). 3. Perform two double-loop sutures at proximal and distal end of tenorrhaphy (arrows). 4. Perform eight running cross stitches at the radial side (R) and 5. ulnar side (U) of the tenorrhaphy. 6. WF tenorrhaphy (the overlap has been reduced to approximately 27 mm due to interlacing of tendons).
Fig 3.
Effects of suture techniques Pulvertaft (PT), Fridén (FR) and Woven-Fridén (WF) on bulk ratio in % (ratio of the cross-sectional area of the sutured tendons and the native tendons; for details see S1 Data).
Data is expressed as means, standard deviation bars are shown. Different superscripts indicate statistically significant differences among groups at p < 0.001. For each experimental group, 12 side-to-side tenorrhaphies were tested.
Fig 4.
Effects of suture techniques Pulvertaft (PT), Fridén (FR) and Woven-Fridén (WF) on stiffness (resistance of sutures to deformation) in N/mm (crosshatched bars) and on ultimate load in N (single-colour bars).
Data is expressed as means, standard deviation bars are shown. Different superscripts indicate statistically significant differences among groups at p < 0.05 and for WF vs. PT at p < 0.0001. For each experimental group, 12 side-to-side tenorrhaphies were tested.