J Hand Microsurg 2023; 15(01): 059-066
DOI: 10.1055/s-0041-1727297
Original Article

Running Interlocking Horizontal Mattress—A New Technique versus Modified Kessler in Extensor Tendon Injuries: A Comparative Study

Rohit Shaju
1   Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, Delhi, India
Sunil Sharma
1   Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, Delhi, India
Kshiteej Dhull
1   Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, Delhi, India
› Author Affiliations


Introduction Pursuit for a new technique, which could be placed on flat extensor tendons and strong enough to withstand the tension forces of early mobilization to prevent stiffness, started few decades ago. We evaluated the new technique of tendon repair using running interlocking horizontal mattress (RIHM) sutures followed by early controlled motion protocol in traumatic extensor tendon injuries and compared it to modified Kessler technique.

Materials and Methods We conducted a prospective randomized interventional study of 18 months' duration, with 30 patients. A total of 103 tendons were repaired, of which 58 were repaired using modified Kessler technique and 45 were repaired using RIHM technique. Postoperatively, patients underwent the early controlled motion protocol and the results were evaluated using the criteria of Miller.

Results Majority of the patients had excellent results (53.3%) and 46.67% had good results in the RIHM group while most of the patients in modified Kessler group had only fair results (80%), and only 20% had good results while none had excellent results.

Conclusion RIHM suture is an easy-to-learn and effective technique for tendon repair with comparable operative duration and with better overall result than modified Kessler technique.

Publication History

Article published online:
13 April 2021

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