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The resurgence of barbed suture and connecting devices for use in flexor tendon tenorrhaphy

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Abstract

Barbed sutures and connecting devices have been historically described and used in flexor tendon tenorrhaphies. With the improvement in biomaterial, we have witnessed recently the resurgence of this concept. In this article, we review the historical use of barbed devices in repairing flexor tendons and explore the available barbed surgical devices that have been described in recent years.

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References

  1. Alcamo JH. US patent number 3,123,077;1956.

  2. Allieu Y. 1977 Note De Catamnese—L’utilisation du Barb-Wire de Jenning en chirurgie de la main. Ann Chir. 1977;31:359–61.

    PubMed  CAS  Google Scholar 

  3. Bunnell S. Gig pull-out suture for tendons. J Bone Joint Surg Am. 1954;36-A(4):850–1.

    PubMed  CAS  Google Scholar 

  4. Cannon NM, Strickland JW. Therapy following flexor tendon surgery. Hand Clin. 1985;1:147–65.

    PubMed  CAS  Google Scholar 

  5. Cooney WP, Weidman K, Malo D, et al. Management of acute flexor tendon injury in the hand. Instr Course Lect. 1985;34:373–81.

    PubMed  CAS  Google Scholar 

  6. Elhassan B, Moran SL, Bravo C, et al. Factors that influence the outcome of zone I and zone II flexor tendon repairs in children. J Hand Surg Am. 2006;31(10):1661–6.

    Article  PubMed  Google Scholar 

  7. Hagberg L, Selvik G. Tendon excursion and dehiscence during early controlled mobilization after flexor tendon repair in zone II: an x-ray stereophotogrammetric analysis. J Hand Surg Am. 1991;16(4):669–80.

    Article  PubMed  CAS  Google Scholar 

  8. Hirpara KM, Sullivan PJ, O’Sullivan ME. A new barbed device for repair of flexor tendons. J Bone Joint Surg Br. 2010;92(8):1165–70.

    Article  PubMed  CAS  Google Scholar 

  9. Ingle NP, King MW. Optimizing the tissue anchoring performance of barbed sutures in skin and tendon tissues. J Biomech. 2010;43(2):302–9.

    Article  PubMed  CAS  Google Scholar 

  10. Ingle NP, King MW, Zikry MA. Finite element analysis of barbed sutures in skin and tendon tissues. J Biomech. 2010;43(5):879–86.

    Article  PubMed  CAS  Google Scholar 

  11. Jennings ER. Tendon sutures. Md State Med J. 1954;3(1):17–8.

    PubMed  CAS  Google Scholar 

  12. Jennings ER, Mansberger Jr AR, Smith EP, et al. A new technique in primary tendon repair. Surg Gynecol Obstet. 1952;95(5):597–600.

    PubMed  CAS  Google Scholar 

  13. Jennings ER, Yeager GH. Barbwire tendon suture; clinical experience with thirty flexor tendons. AMA Arch Surg. 1955;70(4):566–9.

    PubMed  CAS  Google Scholar 

  14. Khanna A, Gougoulias N, Maffulli N. Modalities in prevention of flexor tendon adhesion in the hand: what have we achieved so far? Acta Orthop Belg. 2009;75(4):433–44.

    PubMed  Google Scholar 

  15. Kim PT, Aoki M, Tokita F, et al. Tensile strength of cross-stitch epitenon suture. J Hand Surg. 1996;21(6):821–3.

    CAS  Google Scholar 

  16. Lengemann F. A new wire tendon suture. Zentrabl Chir. 1951;76(14):964–7.

    CAS  Google Scholar 

  17. Marin Braun F, Foucher G, Buch Jaeger N, et al. Repair of the flexor digitorum profundus and the flexor pollicis longus by the “rope down” technique. Results in a series of 77 cases. Ann Chir Main Memb Super. 1991;10(1):13–21.

    Article  PubMed  CAS  Google Scholar 

  18. Mckee GK. Metal anastomosis tubes in tendon suture. Lancet. 1945;245(6352):659–60.

    Article  Google Scholar 

  19. McKenzie AR. An experimental multiple barbed suture for the long flexor tendons of the palm and fingers. Preliminary report. J Bone Joint Surg Br. 1967;49(3):440–7.

    PubMed  CAS  Google Scholar 

  20. McKenzie AR. Function after reconstruction of severed long flexor tendons of the hand. A review of 297 tendons. J Bone Joint Surg Br. 1967;49(3):424–39.

    PubMed  CAS  Google Scholar 

  21. Momose T, Amadio PC, Zhao C, Zobitz ME, et al. The effect of knot location, suture material, and suture size on the gliding resistance of flexor tendons. J Biomed Mater Res. 2000;53(6):806–11.

    Article  PubMed  CAS  Google Scholar 

  22. Momose T, Amadio PC, Zhao C, et al. Suture techniques with high breaking strength and low gliding resistance: experiments in the dog flexor digitorum profundus tendon. Acta Orthop Scand. 2001;72(6):635–41.

    Article  PubMed  CAS  Google Scholar 

  23. Moriya T, Zhao C, An KN, et al. The effect of epitendinous suture technique on gliding resistance during cyclic motion after flexor tendon repair: a cadaveric study. J Hand Surg. 2010;35(4):552–8.

    Article  Google Scholar 

  24. Moriya T, Zhao C, Yamashita T, et al. Effect of core suture technique and type on the gliding resistance during cyclic motion following flexor tendon repair: a cadaveric study. J Orthop Res. 2010;28(11):1475–81 (Research support, Non-US Government).

    Article  PubMed  Google Scholar 

  25. Morizaki Y, Zhao C, An KN, et al. The effects of platelet-rich plasma on bone marrow stromal cell transplants for tendon healing in vitro. J Hand Surg. 2010;35(11):1833–41.

    Article  Google Scholar 

  26. Parikh PM, Davison SP, Higgins JP. Barbed suture tenorrhaphy: an ex vivo biomechanical analysis. Plast Reconstr Surg. 2009;124(5):1551–8.

    Article  PubMed  CAS  Google Scholar 

  27. Rezvani H. Use of “Barb-wire” for repair of flexor tendons of the fingers. Apropos of 18 cases. Bull Mem Soc Chir Paris. 1974;63(2):107–13.

    PubMed  CAS  Google Scholar 

  28. Rocchi L, Merolli A, Genzini A, et al. Flexor tendon injuries of the hand treated with TenoFix: mid-term results. J Orthop Traumatol. 2008;9(4):201–8.

    Article  PubMed  Google Scholar 

  29. Shaw PC. A method of flexor tendon suture. J Bone Joint Surg Br. 1968;50(3):578–87.

    PubMed  CAS  Google Scholar 

  30. Strickland JW. Flexor tendon repair. Hand Clin. 1985;1(1):55–68.

    PubMed  CAS  Google Scholar 

  31. Strickland JW. Results of flexor tendon surgery in zone II. Hand Clin. 1985;1(1):167–79.

    PubMed  CAS  Google Scholar 

  32. Strickland JW. Flexor tendon injuries: II. Operative technique. J Am Acad Orthop Surg. 1995;3(1):55–62.

    PubMed  Google Scholar 

  33. Strickland JW. Development of flexor tendon surgery: twenty-five years of progress. J Hand Surg. 2000;25(2):214–35.

    Article  CAS  Google Scholar 

  34. Strickland JW. The scientific basis for advances in flexor tendon surgery. J Hand Ther. 2005;18(2):94–110. quiz 111.

    Article  PubMed  Google Scholar 

  35. Su BW, Protopsaltis TS, Koff MF, et al. The biomechanical analysis of a tendon fixation device for flexor tendon repair. J Hand Surg. 2005;30(2):237–45.

    Article  Google Scholar 

  36. Su BW, Solomons M, Barrow A, et al. Device for zone-II flexor tendon repair. A multicenter, randomized, blinded, clinical trial. J Bone Joint Surg Am. 2005;87(5):923–35.

    Article  PubMed  Google Scholar 

  37. Thurman RT, Trumble TE, Hanel DP, et al. Two-, four-, and six-strand zone II flexor tendon repairs: an in situ biomechanical comparison using a cadaver model. J Hand Surg. 1998;23(2):261–5.

    Article  CAS  Google Scholar 

  38. Trocchia AM, Aho HN, Sobol G. A re-exploration of the use of barbed sutures in flexor tendon repairs. Orthopedics. 2009;32(10):731.

    Article  Google Scholar 

  39. Winters SC, Gelberman RH, Woo SL, et al. The effects of multiple-strand suture methods on the strength and excursion of repaired intrasynovial flexor tendons: a biomechanical study in dogs. J Hand Surg. 1998;23(1):97–104.

    Article  CAS  Google Scholar 

  40. Wolfe SW, Willis AA, Campbell D, et al. Biomechanic comparison of the Teno Fix tendon repair device with the cruciate and modified Kessler techniques. J Hand Surg. 2007;32(3):356–66.

    Article  Google Scholar 

  41. Zhao C, Amadio PC, Momose T, et al. The effect of suture technique on adhesion formation after flexor tendon repair for partial lacerations in a canine model. J Trauma. 2001;51(5):917–21.

    Article  PubMed  CAS  Google Scholar 

  42. Zhao C, Amadio PC, Zobitz ME, et al. Gliding characteristics of tendon repair in canine flexor digitorum profundus tendons. J Orthop Res. 2001;19(4):580–6.

    Article  PubMed  CAS  Google Scholar 

  43. Zhao C, Amadio PC, Zobitz ME, et al. Gliding resistance after repair of partially lacerated human flexor digitorum profundus tendon in vitro. Clin Biomech. 2001;16(8):696–701.

    Article  CAS  Google Scholar 

  44. Zhao C, Sun YL, Ikeda J, et al. Improvement of flexor tendon reconstruction with carbodiimide-derivatized hyaluronic acid and gelatin-modified intrasynovial allografts: study of a primary repair failure model. J Bone Joint Surg Am. 2010;92(17):2817–28.

    Article  PubMed  Google Scholar 

  45. Zhao C, Zobitz ME, Sun YL, et al. Surface treatment with 5-fluorouracil after flexor tendon repair in a canine in vivo model. J Bone Joint Surg Am. 2009;91(11):2673–82.

    Article  PubMed  Google Scholar 

  46. Zobitz ME, Zhao C, Amadio PC, et al. Comparison of mechanical properties of various suture repair techniques in a partially lacerated tendon. J Biomech Eng. 2000;122(6):604–7.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Orthopedic Biomechanics Laboratory, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Yazeed Mazen Gussous, Chunfeng Zhao, Peter C. Amadio & Kai-Nan An

Authors
  1. Yazeed Mazen Gussous
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  2. Chunfeng Zhao
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  3. Peter C. Amadio
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  4. Kai-Nan An
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Corresponding author

Correspondence to Chunfeng Zhao.

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Gussous, Y.M., Zhao, C., Amadio, P.C. et al. The resurgence of barbed suture and connecting devices for use in flexor tendon tenorrhaphy. HAND 6, 268–275 (2011). https://doi.org/10.1007/s11552-011-9344-6

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  • DOI: https://doi.org/10.1007/s11552-011-9344-6

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