Flexor tendon repair strength is proportional to the number of suture strands crossing the repair site but it is not clear if each strand needs to result from a separate pass through the tendon. We examined whether one throw of looped suture across a repair site equals two separate throws of suture and whether fewer passes with stronger material such as Fiberwire is equivalent to more passes with a comparatively weaker material such as Supramid. When evaluating the repairs for force required to generate a 2 mm gap and for gap formed at the instant prior to failure, looped suture cannot substitute for two separate passes of suture (Supramid Kessler looped vs. separate passes, 14 N vs. 35 N and 8.8 mm vs. 4.1 mm, respectively; Fiberwire Kessler looped vs. separate passes, 25 N vs. 43 N and 7.6 mm vs. 4.6 mm, respectively; all p 0.05).
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