Dear Sir, The goal of flexor tendon repair is to achieve a repair of sufficient strength that allows early active mobilization. Biomechanical studies have shown that the strength of a flexor tendon repair is roughly proportional to the number of suture strands that cross the repair site (Savage and Risitano, 1989). However, an increase in the number of suture strands comes at the cost of increased operative time, expertise and manipulation of the tendon. The introduction of looped sutures (Tsuge et al., 1975) doubled the number of suture strands with each pass, simplified suture locking and minimized tendon handling. Despite these advantages, the cost of these sutures remains a significant barrier to the widespread adoption of its use. We describe a technique for making a looped suture using a 23G hypodermic needle and a 4-0 prolene suture (Ethicon Inc., Somerville, NJ, USA).
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