Strength of Tendon Suture technique Samu Modification SM Formation of connection gap Kessler Modification KM

2. Formation of tendon connection gap with Kessler Modification KM

technique Based on Table 5.5 can be known that of all samples that exist in the treatment group Kessler modification techniques KM most of the gap formed on the load to 600 grams and a small portion is formed on the load to 400 grams. According to Rizal 2010 that the increased of tendon connections gap, provide poor clinical outcome. At tendon grafting, the formation of gap has effect on adhesion formation in the tendon, so it will affect the function of tendon gliding. This Kessler Modification KM suture technique, according to the researchers is too many punctures suture that surrounds the tendon rupture so that allow the occurence of re- rupture, in addition, the technique of Kessler Modification KM use the more yarn that technique of Samu Modification SM. Besides mobilization also influence the formation of the connection gap in the tendons that larger so as to facilitate re- rupture in the tendon connection. One that affects the formation of this gap is early mobilization of tendon that has been spliced, with this early mobilization, the movement of the tendon will be maximized, so that if the tendon suture is not strong, the tendon will be easy to form gap, when the gap has been formed, it can reduce the strength of tendon suture. In addition to reducing the strength of the tendon suture, the gap formation will facilitate the occurrence adhesion or new tissue that will disturb the process of the tendon gliding, when the tendon gliding is disturb the functionof the tendons that rupture and have sewn will not be optimal. While the purpose of suturing or grafting tendons is splicing the ends of a ruptured tendon in such a way so as to allow the healing process occurs. One target of the connecting tendon is to repair or maintain the function of the tendon gliding. the more minimal gap 748 tendon connection is formed, the better the tendon gliding function because no tissues that out of the tendon gap. Sutures should be strong enough to withstand the movement during the early mobilization without damaging the structure of tissue, in the tendon that could inhibit the healing process of the tendon itself.. If we compare it with the technique of Samu Modification SM, suture technique of Kessler modification KM is less powerful, it can beseen in the formation of a gap in the group of Kessler Modification KM technique which is a small portion is formed on the load of 400 grams, while in the group of Samu Modifications SM technique, most of small gap if formed at the load of 700 grams. This proves that the formation of the gap connection of Kessler Modification KM technique is less powerful than suture techniques of Samu Modification SM. early gap that formed on Kessler Modification KM techniques, can also be influenced by the size of the thread that used is large enough, which is in thisresearch, the technique of Kessler modification use proline threads 4.0 and 6.0, while the techniqueof Samu Modification only use proline threads 6.0 that certainly smaller than threads used in the technique of Kessler Modification KM.

3. Strenght of tendon suture in Samu Modification SM technique

Based on Table 5.3 can be known that of all samples that exist in the treatment group Samu modification techniques SM mostly including in strong category. In addition to the smooth workings gentle and fine instrument , in the process of surgery should be using a magnifying glass. This is to provide optimal results in grafting tendons Rizal, 2004. According to Surya 2004 tendon suture strength is determined by several factors: the type of yarn, thread strength and technique or