Wang Qiao, Wong Yoke Rung, McGROUTHER Duncan Angus
Department of Hand Surgery and Reconstructive Microsurgery, Singapore General Hospital, Singapore.
Biomechanics Laboratory, Singapore General Hospital, Singapore.
J Hand Surg Asian Pac Vol. 2022 Jun;27(3):473-479. doi: 10.1142/S2424835522500448.
Massachusetts General Hospital (MGH) repair is one of the widely used 4-strand flexor tendon repair techniques. However, it uses two single strand sutures that are each passed twice across the repair site. This is time consuming and may cause imbalance of the load across the repair. We modified the MGH repair by using a looped suture and call it the looped MGH repair. The aim of this study is to compare the strength of the looped MGH repair performed with three different looped sutures against the strength of original MGH repair. Forty porcine flexors were used for the study. The original MGH repair was performed with Prolene 4-0. Looped MGH repair was performed with three different loop sutures, Supramid 4-0, Tendo-Loop 4-0 and FiberLoop 4-0. Mechanism of failure, ultimate tensile strength, stiffness, load to 2-mm gap formation and repair time were recorded for comparison. There was no significant difference between the original MGH repair and the looped repair using Supramid regarding their biomechanical performance. Looped MGH repair using Tendo-Loop and FiberLoop showed significantly higher ultimate tensile strength and FiberLoop had highest 2-mm gap force. All looped MGH repairs required significant less time compared to original MGH repair. Our modification of the MGH repair using a looped Supramid 4-0 suture took significantly lesser time to perform while providing the same strength as the original MGH repair using Prolene 4-0. The use of the FiberLoop 4-0 provided significantly greater strength while taking lesser time.
马萨诸塞州总医院（MGH）修复术是广泛应用的四股屈肌腱修复技术之一。然而，它使用两根单股缝线，每根缝线都要在修复部位穿过两次。这既耗时，又可能导致修复部位的负荷不均衡。我们通过使用环形缝线对MGH修复术进行了改良，并将其称为环形MGH修复术。本研究的目的是比较使用三种不同环形缝线进行的环形MGH修复术与原始MGH修复术的强度。该研究使用了40条猪的屈肌腱。原始MGH修复术使用4-0普理灵缝线进行。环形MGH修复术使用三种不同的环形缝线进行，即4-0 Supramid缝线、4-0 Tendo-Loop缝线和4-0 FiberLoop缝线。记录失败机制、极限抗拉强度、刚度、形成2毫米间隙所需的负荷以及修复时间以作比较。原始MGH修复术与使用Supramid缝线的环形修复术在生物力学性能方面没有显著差异。使用Tendo-Loop和FiberLoop缝线的环形MGH修复术显示出显著更高的极限抗拉强度，且FiberLoop缝线具有最高的2毫米间隙力。与原始MGH修复术相比，所有环形MGH修复术所需时间都显著更少。我们使用4-0环形Supramid缝线对MGH修复术进行的改良在操作时所需时间显著更少，同时能提供与使用4-0普理灵缝线的原始MGH修复术相同的强度。使用4-0 FiberLoop缝线在所需时间更少的同时能提供显著更高的强度。
