OBJECTIVE To determine the effect of epitendinous suture (ES) caliber on the tensile strength of flexor tendon repairs in cadaveric specimens from dogs. SAMPLE 60 cadaveric superficial digital flexor tendons (SDFTs) from 30 skeletally mature dogs. PROCEDURES Specimens were randomly assigned to 5 suture caliber groups (n = 12 SDFTs/group). After sharp transection, SDFTs were repaired by placement of a simple continuous circumferential ES created with size-0, 2–0, 3–0, 4–0, or 5–0 polypropylene suture. Constructs were preloaded to 2 N and load tested to failure. Loads at yield, peak, and failure and mode of failure were compared among groups by statistical methods. RESULTS Yield, peak, and failure loads for SDFT repair constructs were positively correlated with ES caliber and did not differ between the size-0 and 2–0 groups on pairwise comparisons. Yield load was significantly greater for size-0, 2–0, and 3–0 groups than for the 4–0 and 5–0 groups. Peak and failure loads were significantly greater for the size-0 and 2–0 groups than for the remaining groups. Most size-0 (12/12), 2–0 (12/12), and 3–0 (10/12) group constructs failed because of ES pull-through; several constructs in the 4–0 group (5/12) and most in the 5–0 group (11/12) failed because of ES breakage. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested size-0 and 2–0 sutures should be considered when placing an ES for flexor tendon repairs in dogs. However, in vivo studies are needed determine the effects of increasing ES caliber on clinical outcomes for dogs undergoing these procedures.

OBJECTIVE To compare tensile strength and time to completion of body wall closure among 3 suture patterns. SAMPLE Eighteen 5 × 5-cm leather specimens and sixty-eight 5 × 5-cm full-thickness tissue specimens from the ventral portion of the abdominal body wall of 17 canine cadavers. PROCEDURES During experiment 1 of a 2-experiment study, each leather specimen was cut in half and sutured with a simple interrupted or simple continuous pattern or continuous pattern with intermittent Aberdeen knots (intermittent Aberdeen pattern). During experiment 2, 4 tissue specimens were obtained from each cadaver; the linea alba of 3 specimens was incised and closed with 1 of the 3 suture patterns evaluated in experiment 1, and the fourth specimen was left intact as a control. All leather and tissue specimens underwent mechanical testing. Time to completion, mode of failure, and maximum force at failure (Fmax) were compared among the suture patterns. RESULTS In experiment 1, the mean Fmax for the simple continuous and intermittent Aberdeen patterns was significantly greater than that for the simple interrupted pattern. In experiment 2, the mean Fmax for specimens obtained cranial to the umbilicus was greater than that for specimens obtained caudal to the umbilicus, and the mean time to completion for both continuous suture patterns was significantly less than that for the simple interrupted pattern. Most (34/51) sutured tissue specimens failed because the suture cut through the tissue at the suture-tissue interface. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that the intermittent Aberdeen pattern may be an alternative for body wall closure in dogs.

Objective: To compare the mechanical characteristics of polymerized caprolactam and monofilament nylon loops with those of the cranial cruciate ligament (CCL) in cattle. Sample: 6 femorotibial joints harvested from 3 cows and suture constructs made from No. 8 polymerized caprolactam, 80-lb test monofilament nylon fishing line, and 450-lb test monofilament nylon fishing line. Procedures: Joints were cleared of soft tissue structures except the CCL, connected to a load frame, and loaded to failure while measuring force and elongation. Synthetic constructs tested in a similar manner included single-stranded and 3-stranded No. 8 polymerized caprolactam, 3- and 6-stranded 80-lb test monofilament nylon fishing line, and 3- and 6-stranded 450-lb test monofilament nylon fishing line. Results: The CCL ruptured at a mean ± SD force of 4,541 ± 1,417 N with an elongation of 2.0 ± 0.3 cm. The tensile strength of 3-stranded 450-lb test monofilament nylon fishing line was similar to that of the CCL, rupturing at loads of 5,310 ± 369 N (braided strands) and 6,260 ± 239 N (parallel strands). Elongation was greater for braided constructs. Conclusions and Clinical Relevance: The 3-stranded cords of 450-lb test monofilament nylon fishing line most closely approximated the strength of the CCL. Marked increases in elongation occur when large-sized materials are constructed in braided configurations, and this elongation would likely not provide stability in CCL-deficient stifle joints. Additional studies are needed to determine whether any of these materials are suitable CCL replacements in cattle.

Holding power was determined for various orthopedic screws in bones of calves. Holding power was defined as maximal tensile force required to remove a screw divided by thickness of bone engaged by the screw (kN/mm). Comparative pull-out tests were performed, using pairs of large metacarpal or metatarsal bones from calves aged 3 to 14 days. Comparisons were made of the holding power of 6.5-mm fully threaded cancellous screws and 5.5-mm cortical screws in the proximal and distal metaphyses, and of 4.5-mm and 5.5-mm cortical screws in the diaphysis. Sixteen repetitions of each comparative trial were performed. There was no statistically significant difference in the holding power of 4.5- and 5.5-mm cortical screws in the diaphysis. There was no significant difference in the holding power of 5.5-mm cortical and 6.5-mm fully threaded cancellous screws in the proximal metaphysis. In the distal metaphysis, 6.5-nu-n fully threaded cancellous screws had significantly (P < 0.001) greater holding power than did 5.5-mm cortical screws. There was no significant difference between the mean holding power of 5.5-mm cortical screws in the proximal metaphysis and 5.5-mm cortical screws in the distal metaphysis. There was significantly (P < 0.01) greater mean holding power of 6.5-mm cortical, fully threaded cancellous screws in the distal metaphysis, compared with the proximal metaphysis.

OBJECTIVE To evaluate effects of bite distance of an interlocking horizontal mattress epitendinous suture (IHMES) from the repair site on tensile strength of canine tendon repairs. SAMPLE 72 canine cadaveric superficial digital flexor tendons (SDFTs). PROCEDURES Transverse tenotomy was performed, and SDFTs were repaired with a locking-loop construct (LL construct) or 3 LL constructs with IHMES suture bites placed 5 (LL + 5ES construct), 10 (LL + 10ES construct), or 15 (LL + 15ES construct) mm from the transection site (18 SDFTs/group). Constructs were loaded to failure. Load at 1− and 3-mm gapping, yield force, failure load, and failure mode were evaluated. RESULTS Mean ± SD yield force and failure load for LL constructs were significantly lower than for IHMES constructs. Load at 1− and 3-mm gapping was significantly higher for IHMES constructs. Increasing the bite distance significantly increased construct strength (134.4 ± 26.1 N, 151.0 ± 16.8 N, and 182.1 ± 23.6 N for LL + 5ES, LL + 10ES, and LL + 15ES constructs, respectively), compared with strength for the LL construct. Failure mode differed significantly among constructs when an IHMES was used. CONCLUSIONS AND CLINICAL RELEVANCE Addition of an IHMES to an LL construct led to increased ultimate tensile strength by 2.5 times and significantly reduced gap formation. Increasing the IHMES bite distance increased yield force by 2.1, 2.3, and 2.7 times for bites placed 5, 10, and 15 mm from the tenotomy, respectively. Positioning an IHMES at a greater distance from the repair site provided superior biomechanical strength for tendon repairs in dogs.

Objective-To describe a novel interlocking nail (ILN) and locking system and compare the torsional properties of constructs implanted with the novel ILN or a standard 8-mm ILN (ILN8) by use of a gap-fracture model. Sample Population-8 synthetic specimens modeled from canine tibiae. Procedures-An hourglass-shaped ILN featuring a tapered locking mechanism was designed. A synthetic bone model was custom-made to represent canine tibiae with a 50-mm comminuted diaphyseal fracture. Specimens were repaired by use of a novel ILN or an ILN8 with screws. Specimens were loaded for torsional measurements. Construct compliance and angular deformation were compared. Results-Compliance of the ILN8 was significantly smaller than that of the novel ILN. Mean +/- SD maximum angular deformation of the ILN8 construct (23.12 +/- 0.65 degrees) was significantly greater, compared with that of the novel ILN construct (9.45 +/- 0.22 degrees). Mean construct slack for the ILN8 group was 15.15 +/- 0.63 degrees, whereas no slack was detected for the novel ILN construct. Mean angular deformation for the ILN8 construct once slack was overcome was significantly less, compared with that of the novel ILN construct. Conclusions and Clinical Relevance-Analysis of results of this study suggests that engineering of the locking mechanism enabled the novel hourglass-shaped ILN system to eliminate torsional instability associated with the use of current ILNs. Considering the potential deleterious effect of torsional deformation on bone healing, the novel ILN may represent a biomechanically more effective fixation method, compared with current ILNs, for the treatment of comminuted diaphyseal fractures.

Two test specimens of skin were cut from the lateral aspect of each hind limb of 9 rats. Specimens were contiguous, thereby providing matched pairs. One specimen was immediately placed in liquid nitrogen for 5 minutes, then stored at -70 C and tested within 3 to 4 weeks. Within 5 minutes of harvest, the second specimen was used for immediate material testing. Basic engineering material tests were used to measure strength, loading response, and elastic and viscous properties. Each matched pair of tissues was used for the same procedure. Quasistatic uniaxial tensile tests were used to apply deformations to the test specimens, and resulting loads were recorded. Stress and strain were calculated from the recorded data, providing information on yield strength, ultimate strength, fracture strength, and loading response. Each matched pair of specimens represented 1 repetition; 6 repetitions were made of each observation. Statistical analysis indicated that tissue freezing significantly (P<0.05) increased fracture strength, but did not affect strength, ultimate strength, or loading response. Dynamic vibration response tests were used to find mechanical mobility of the specimens, thereby providing information on elastic and viscous behaviors, which were quantified by calculation of spring and damping coefficients, respectively. As before, 6 repetitions were used. Statistical analysis indicated that tissue freezing did not affect these coefficients.

The breaking strength (stress at failure) of equine third metacarpal bones, with and without clustered drill holes, was determined in vitro. Paired ossa metacarpalia II-IV of 39 horses (n = 39) between 2 and 7 years old were tested in palmarodorsal 3-point bending. Four treatments were compared. Clustered 2.7- or 3.5-mm drill holes, in a 4- or 7-hole pattern, were made in the dorsal cortex of the distal diaphysis of the left third metacarpal bone. Undrilled right third metacarpi were used as controls. Bones with clustered drill holes failed by an oblique fracture through 1 or more drill holes, whereas undrilled bones failed with a middiaphyseal transverse fracture. Clustered drill holes acted as a stress concentrator and significantly (P < 0.05) decreased the stress required for failure. However, differences in breaking strength between treatment groups were not significant (P > 0.05).

OBJECTIVE To evaluate the effect of suture caliber on the tensile strength of tenorrhaphies performed with a locking-loop technique in cadaveric canine tendons SAMPLE 60 superficial digital flexor tendons (SDFTs) from 30 cadaveric adult dogs. PROCEDURES Transverse tenotomy was performed, and SDFTs were repaired with a locking-loop technique and polypropylene suture of 5 randomly assigned calibers: size-0, 2-0, 3-0, 4-0, or 5-0 (n = 12 SDFTs/suture caliber). Tendon constructs were tested to failure. Yield, peak, and failure forces and causes of failure were compared between groups. RESULTS Mean ± SD failure force for the constructs was significantly greater with large-caliber suture (size-0: 73.5 ± 3.1 N; size 2-0: 54.4 ± 7.1 N; size 3-0: 28.7 ± 4.9 N; size 4-0: 18.7 ± 3.4 N; and size 5-0: 8.8 ± 2.8 N). The likelihood of construct failure by suture pullout through the tendon substance increased with large-caliber suture (size-0: 12/12), whereas the likelihood of construct failure by suture breakage increased with small-caliber suture (2-0: 10/12; 3-0, 4-0, and 5-0: 12/12 each). CONCLUSIONS AND CLINICAL RELEVANCE Large-caliber suture had greater tensile strength for tenorrhaphies performed with a locking-loop technique in cadaveric canine tendons. Prior to the use of large-caliber suture in patients requiring tenorrhaphy, however, in vivo studies are required to confirm the results obtained here.

OBJECTIVE To evaluate the effect of exposure to a balanced electrolyte solution (BES), or equine abdominal fat on the knot-holding capacity (KHC), relative knot security (RKS), weight, and volume of forwarder knots versus surgeon's knots. SAMPLE 315 knots tied and tested in vitro. PROCEDURES United States Pharmacopeia size-3 polyglactin 910 suture exposed to air (dry [control]), equine abdominal fat (fat-exposed), or BES (BES-exposed) was used to tie forwarder knots with 2, 3, and 4 throws and surgeon's knots with 5, 6, 7, and 8 throws. A universal materials testing machine was used to test the tensile strength of suture and knots to failure, and the KHC, RKS, weight, and volume of knots were determined. RESULTS Forwarder knots had significantly higher KHC and RKS and lower volume, compared with surgeons’ knots. Forwarder knots tied with fat-exposed suture had greater weight, but not volume, than did forwarder knots tied with dry or BES-exposed suture with the same number of throws. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that forwarder knots were superior to surgeon's knots when configured as start knots intended for continuous lines of suture. Exposure to media did not negatively affect mechanical or physical properties of forwarder knots and may improve specific biomechanical functions, including KHC and RKS.