{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:59:39Z","timestamp":1777661979879,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T00:00:00Z","timestamp":1640649600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Multiple techniques for the repair of flexor tendon injuries in zone 1 have been proposed over time. While pull-out suture techniques and bone anchor seem to be stronger than internal suture techniques, they are associated with a higher complication rate. We therefore developed an alternative internal suture repair with similar biomechanical stability to those of pull-out sutures and bone anchors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Twenty porcine distal phalanges and deep flexor tendons were randomized to 2 groups of 10 each. The tendons were transsected at the level of the distal interphalangeal joint. In group 1, repairs were performed with a well-established intraosseous suture repair and in group 2 with our new multistrand technique. The repairs were biomechanically tested with linear distraction until failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We recorded a significantly higher 2-mm gap force (2GF)\u2014and thus higher stability\u2014of the repairs in group 1 in comparison to group 2. With a 2GF of more than 50 N, our suture technique allows for a modern early active motion rehabilitation protocol. Breakage of the suture construct occurred at random places in the repair in both groups. No pull-outs were noted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This study presents a strong transosseous multistrand repair technique for flexor tendon repair in zone 1 that is simple and fast to perform and should have enough strength to withstand early active motion rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447211060430","type":"journal-article","created":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T01:33:52Z","timestamp":1640741632000},"page":"628-634","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["The Transosseous Internal Four Strand Technique: A New All-Inside Technique for Zone 1 Flexor Tendon Repairs"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2069-2855","authenticated-orcid":false,"given":"Patrick S.","family":"Harenberg","sequence":"first","affiliation":[{"name":"BG University Hospital Bergmannsheil Bochum, Germany"},{"name":"Kantonsspital St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg G.","family":"Gr\u00fcnert","sequence":"additional","affiliation":[{"name":"Kantonsspital St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel M.","family":"Christen","sequence":"additional","affiliation":[{"name":"Kantonsspital St. Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,12,28]]},"reference":[{"key":"bibr1-15589447211060430","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(40)90160-X"},{"key":"bibr2-15589447211060430","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-199408000-00016"},{"key":"bibr3-15589447211060430","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(98)80099-3"},{"key":"bibr4-15589447211060430","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(84)80207-5"},{"key":"bibr5-15589447211060430","doi-asserted-by":"publisher","DOI":"10.1016\/S0266-7681(02)00362-5"},{"key":"bibr6-15589447211060430","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2013.04.026"},{"key":"bibr7-15589447211060430","doi-asserted-by":"publisher","DOI":"10.1016\/S0753-9053(82)80050-1"},{"key":"bibr8-15589447211060430","first-page":"119","volume":"11","author":"Mantero R","year":"1973","journal-title":"Riv Chir 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