Ex vivo Mechanical Testing of Various Suture Patterns for Use in Plating as a Repair Method for Tendon Rupture

Introduction: There is some evidence that tendon plating may be a superior method of maintaining tendon apposition during the healing process, but the literature currently describes multiple suture patterns used to attach the plate to the tendon with no evidence of efficacy. The present study seeks to examine the differences between the suture patterns currently described as well as a novel pattern.

Materials and Methods: The suspensory ligament and digital flexor tendons were harvested from 16 neonatal foals. Each tendon/ligament was transected midbody and randomly assigned to test groups using either simple interrupted or hybrid suture patterns to secure an 8-hole 2.0 mm veterinary cuttable plate to the tendon. The constructs were distracted at a rate of 1.0 mm/sec to failure, as determined by the formation of a 1 mm gap for initial and 3 mm for ultimate failure. The mode of failure was also recorded.

Results: Hybrid (mean = 1 mm: 112 N; 3 mm: 143.6 N) and interrupted (mean = 1 mm: 104.4 N; 3 mm: 140.1 N) patterns sustained significantly higher forces before gap formation than simple interrupted (mean = 1 mm: 47.7 N; 3 mm: 69.3 N) (p < 0.01). There was no significant difference between hybrid and interrupted patterns. All patterns failed predominantly by tissue failure with no difference in failure mode between groups.

Discussion/Conclusion: Both the interrupted and hybrid patterns described herein offer significantly greater resistance to tendon gap formation when compared with a simple interrupted pattern as described previously.

Acknowledgment: No proprietary interest or funding was provided for this project.