{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:44:49Z","timestamp":1761061489662,"version":"build-2065373602"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T00:00:00Z","timestamp":1632441600000},"content-version":"vor","delay-in-days":266,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T00:00:00Z","timestamp":1632441600000},"content-version":"vor","delay-in-days":266,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>In this study we compare the biomechanical properties of a novel suture technique that we developed called the continuous double knots technique for repairing flexor tendon injuries with the standard 4\u2010strand double\u2010modified Kessler technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was an experimental study. Eighty porcine flexor digitorum profundus tendons were harvested and divided randomly into two groups of 40. The first group (<jats:italic>N<\/jats:italic>\u2009=\u200940) was repaired using the 4\u2010strand double modified Kessler technique and the second group (<jats:italic>N<\/jats:italic>\u2009=\u200940) was repaired using our new continuous double knots technique. The two groups were randomly divided and the ultimate failure load (<jats:italic>n<\/jats:italic>\u2009=\u200920) and cyclic testing to failure (<jats:italic>n<\/jats:italic>\u2009=\u200920) were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean ultimate failure load was 25.90\u2009\u00b1\u20097.11 (N) and cyclic testing to failure 88\u2009\u00b1\u200947.87 (cycles) for the 4\u2010strand double modified Kessler technique and 34.56\u2009\u00b1\u20096.60 (N) and 189\u2009\u00b1\u200966.36 (cycles) for our new continuous double knots technique. The T\u2010test revealed a significant difference between the 2 techniques (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). In terms of biomechanical properties in tendon repair, the continuous double knots technique group had a higher tensile strength than the 4\u2010strand double\u2010modified Kessler technique group. There were also significant differences between the ultimate failure load and cyclic testing to failure for the flexor tendon sutures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The continuous double knots technique suture technique had significantly higher maximum tensile strength and cyclic testing than the 4\u2010strand double modified Kessler technique in an in vitro study, and in thus an optional technique for flexor tendon repair.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s40634-021-00404-4","type":"journal-article","created":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T13:04:03Z","timestamp":1632488643000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Biomechanical study of a newly developed continuous double knots technique compared with the 4\u2010strand double\u2010modified Kessler technique for flexor tendon repair"],"prefix":"10.1002","volume":"8","author":[{"given":"Sunton","family":"Wongsiri","sequence":"first","affiliation":[{"name":"Department of Orthopedics Faculty of Medicine Prince of Songkla University Songkhla Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4491-6569","authenticated-orcid":false,"given":"Wongthawat","family":"Liawrungrueang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Faculty of Medicine Prince of Songkla University Songkhla 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participant.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"No conflicts of interest to declare regarding this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"79"}}