Rozov and Kessler Tendon Sutures: Common Properties and Differences

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Abstract

Background. The Kessler suture is one of the most common tendon repair techniques and can be found schematically in most manuals of hand surgery, along with Bunnel and Tsuge sutures. In our country, the seam proposed by V.I. Rozov, while a number of authors believe that Rozov and Kessler sutures are very similar. Both techniques, both the Rozov’s suture and the Kessler suture, have a large number of modifications that differ significantly from the originals, but retain the author’s names, which confuses and hinders the analysis of the use of various methods for restoring the integrity of the tendons.

The aim — to find the correct author’s description of Rozov’s suture and Kessler’s suture, test original techniques on a tendon model, compare techniques, analyze common properties and differences.

Methods. Information was searched in domestic and foreign publications, manuals on traumatology and orthopedics, monographs, methodical letters, materials of congresses, Internet resources. Approbation of the methods was carried out on a tendon model, which was a silicone rod with a diameter of 1 cm.

Results. The first image of the Rozov’s suture discovered by us, dates back to 1958, the original “grasping” technique of flexor tendon repair was proposed by I. Kessler in 1969. These techniques have a number of significant differences in the location of nodes, methods of fixation and planes of threads in the thickness of the tendon.

Conclusion. The data of this study give reason to believe that V.I. Rozov and I. Kessler proposed two different ways of applying a tendon suture.

About the authors

Pavel A. Berezin

Yaroslavl State Medical University

Author for correspondence.
Email: medicinehead@mail.ru
ORCID iD: 0000-0001-8777-2596
Russian Federation, Yaroslavl

Aleksandr S. Zolotov

Far Eastern Federal University

Email: dalexpk@gmail.com
ORCID iD: 0000-0002-0045-9319
Russian Federation, Vladivostok

Rodion D. Volykhin

Vreden National Medical Research Center of Traumatology and Orthopedics

Email: 9gun@bk.ru
ORCID iD: 0000-0001-5407-7044
Russian Federation, St. Petersburg

Elena N. Evdokimova

Arkhangelsk Regional Clinical Hospital

Email: lenalena811@yandex.ru
ORCID iD: 0000-0002-5614-7728
Russian Federation, Arkhangelsk

Lev I. Morozov

Northern State Medical University

Email: morozoff41@yahoo.com
ORCID iD: 0000-0002-0010-1763
Russian Federation, Arkhangelsk

Ilya A. Lazarev

Northern State Medical University

Email: il.lazarevv@yandex.ru
ORCID iD: 0000-0002-3506-8334
Russian Federation, Arkhangelsk

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Supplementary files

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2. Fig.1. Scheme of Rozov suture (1958) [5]

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3. Fig. 2. Scheme of Bloch-Bonnet suture 1958 [5]

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4. Fig. 3. Scheme of Rozov suture (1960) [6]

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5. Fig. 4. Rozov suture: scheme of suture (a); the end of the silicone model stitched according to Rozov in frontal (b) and sagittal (c) planes; appearance of Rozov suture on a silicone model (d)

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6. Fig. 5. Kessler suture (1969): scheme of suture (a); the end of the silicone model stitched according to Kessler in frontal (b) and sagittal (c) planes; Appearance of Kessler suture on a silicone model (d)

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7. Fig. 6. QR code with a link to the video of the Kessler grasping suture

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8. Fig. 7. Tendon repair techniques studied by J.R. Urbaniac et al. [Cited in 12]

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9. Fig. 8. Kessler suture in Urbaniac modification (1973): scheme of Kessler suture in the Urbaniac modification (a); the end of the silicone model stitched according to Kessler in the Urbaniac modification in frontal (b) and sagittal (c) planes; the appearance of the Kessler suture in the modification of Urbaniac on a silicone model (d)

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10. Fig. 9. Scheme of Kirchmayr suture (1917) [12]

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11. Fig. 10. The original suture proposed by S. Bunnel (Published with the permission of the authors) [13]

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12. Fig. 11. Stepwise tendon repair technique using Kessler’s grasping technique [14]

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13. Fig. 12. Scheme of Tajima suture [14]

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14. Fig. 13. Tajima suture (1975): scheme of Tajima suture (a); the end of the silicone model stitched according to Tajima in frontal (b) and sagittal (c) planes; the appearance of the Takima suture on a silicone model (d)

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15. Fig. 14. Schemes of (a) original Rozov suture and original Kessler suture (b)

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Copyright (c) 2022 Berezin P.A., Zolotov A.S., Volykhin R.D., Evdokimova E.N., Morozov L.I., Lazarev I.A.

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