Q Suture Technique: A Suturing Technique to Reduce Gap Formation and Increase Tensile Strength in Tendon Repair

Tendons are connective tissue that attaches the muscles to bones. Damaged tendons can be repaired by stitching their cut ends using the core suturing technique. This procedure still leaves gaps between tendon ends. To reduce any remaining gaps, an additional suturing technique called Q suture is performed.

Begin by placing two incised porcine tendon stumps longitudinally next to each other. For core suturing, mark points at an appropriate distance from the cut tendon end on the anterior and lateral sides. These points help determine the path of the suture.

Insert a longitudinal suture from the cut end. Advance it toward one of the anterior marking points. Pull the suture out from this point. Reinsert it into the nearby lateral marking, making a loop. Pass the suture through the other two markings. Repeat the process with the other stump and knot the sutures to ligate two stumps.

After core suturing, insert the suture on the anterior side of one tendon stump. Loop it on the posterior side of the second stump, spanning the core suture. Withdraw the suture from anterior portion of the second stump. Tie the knots to complete one Q suture. Repeat the process on the opposite side to add the second Q suture.

The repaired tendon is ready for further applications.