{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T23:25:39Z","timestamp":1782861939838,"version":"3.54.5"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2022,9,25]],"date-time":"2022-09-25T00:00:00Z","timestamp":1664064000000},"content-version":"vor","delay-in-days":116,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Indian J Plast Surg"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003The placement of multistrand sutures during flexor tendon repair requires complicated surgical skills; such suturing is difficult. We developed a new, simpler eight-strand suture, which we term the Yoshizu cross-lock. This reduces the numbers of suture passages through the tendons, as well as the numbers of knots.<\/jats:p><jats:p>\n          Methods\u2003Fourteen porcine flexor tendons were transected and repaired using the Yoshizu cross-lock system; no peripheral sutures were placed. Our system is a modification of the published, exposed cross-lock repair method that employs a 4\u20130 monofilament nylon two-strand line and two needles. The repaired tendons were subjected to linear, noncyclic load-to-failure tensile testing. The initial gap, the 2-mm gap force, and the ultimate strength were measured.<\/jats:p><jats:p>\n          Results\u2003The initial gap force was 12.6\u2009\u00b1\u20095.6 Newtons (N), the 2-mm gap force was 33.9\u2009\u00b1\u200910.9\u2009N, and the ultimate strength was 70.1\u2009\u00b1\u200917.0\u2009N. All tendons subjected to Yoshizu cross-lock repair failed due to suture rupture rather than pullout.<\/jats:p><jats:p>\n          Conclusions\u2003Our biomechanical study revealed that Yoshizu cross-lock repair had sufficient tensile strength but was associated with wide variation in the 2-mm gap load (standard deviation\u2009=\u200910.9\u2009N). This study is clinically relevant, showing that the Yoshizu cross-lock repair combined with peripheral suturing may allow a repaired flexor tendon to withstand the stresses encountered during early active mobilization. This simple eight-strand technique will be particularly useful to surgeons who commonly employ the cross-lock stitch for primary flexor tendon repair following early mobilization.<\/jats:p>","DOI":"10.1055\/s-0042-1756132","type":"journal-article","created":{"date-parts":[[2022,9,25]],"date-time":"2022-09-25T22:35:00Z","timestamp":1664145300000},"page":"294-298","source":"Crossref","is-referenced-by-count":3,"title":["Biomechanical Analysis of a New Eight-Strand Suture for Flexor Tendon Repair"],"prefix":"10.1055","volume":"55","author":[{"given":"Koji","family":"Moriya","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Niigata Hand Surgery Foundation, Niigata, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Maki","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Niigata Hand Surgery Foundation, Niigata, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisao","family":"Koda","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Niigata Hand Surgery Foundation, Niigata, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Tsubokawa","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Niigata Hand Surgery Foundation, Niigata, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,9,25]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/0363-5023(94)90224-0","article-title":"Flexor tendon repair in zone II with a new suture technique and an early mobilization program combining passive and active flexion","volume":"19","author":"K L Silfverski\u00f6ld","year":"1994","journal-title":"J Hand Surg 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