{"id":113,"date":"2005-04-19T08:48:12","date_gmt":"2005-04-19T12:48:12","guid":{"rendered":"https:\/\/www.bumc.bu.edu\/surgery\/technical-training\/one-hand-tie\/"},"modified":"2012-05-15T16:10:06","modified_gmt":"2012-05-15T20:10:06","slug":"one-hand-tie","status":"publish","type":"page","link":"https:\/\/www.bumc.bu.edu\/surgery\/training\/technical-training\/one-hand-tie\/","title":{"rendered":"One Hand Tie"},"content":{"rendered":"<h2>One Hand Square Knot<\/h2>\n<h3>Wayne W. LaMorte, M.D., Ph.D., M.P.H.<\/h3>\n<h4>Photography by Michael J. LaMorte<\/h4>\n<p>Two hand ties are generally preferred by most surgeons, but one hand ties can also be used.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand1\" src=\"\/surgery\/files\/2005\/04\/onehand1-400x300.jpg\" alt=\"One Hand 1\" width=\"260\" height=\"193\" \/><\/p>\n<p>1) Note that the short end has been placed beneath the tubing and is held in the right hand, away from the surgeon. The long strand is held in the left hand.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand2\" src=\"\/surgery\/files\/2005\/04\/onehand2-400x300.jpg\" alt=\"One Hand 2\" width=\"260\" height=\"193\" \/><\/p>\n<p>2) The right index finger initiates formation of the first loop by pushing the short strand to the left and above the long strand. The left hand begins to move the long strand to the right.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand3\" src=\"\/surgery\/files\/2005\/04\/1hand3.jpeg\" alt=\"One Hand 3\" width=\"260\" height=\"193\" \/><\/p>\n<p>3) The right index finger is shown inserted into the loop that has been created.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand4\" src=\"\/surgery\/files\/2005\/04\/1hand4.jpeg\" alt=\"One Hand 4\" width=\"260\" height=\"193\" \/><\/p>\n<p>4) The right index finger now begins to roll behind the short strand, which is still being grasped by the thumb and middle finger.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand5\" src=\"\/surgery\/files\/2005\/04\/1hand5.jpeg\" alt=\"One Hand 5\" width=\"260\" height=\"193\" \/><\/p>\n<p>5) The end of the short strand has now been released by the right thumb, and the index finger is being used as a lever to rotate the short end up through the loop.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand6\" src=\"\/surgery\/files\/2005\/04\/1hand6-400x300.jpg\" alt=\"One Hand 6\" width=\"260\" height=\"193\" \/><\/p>\n<p>6) As the short end emerges from the loop, the middle finger pinches it against the forfinger to re-grasp it.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand7\" src=\"\/surgery\/files\/2005\/04\/1hand7-400x300.jpg\" alt=\"One Hand 7\" width=\"260\" height=\"193\" \/><\/p>\n<p>7) And the throw is tightened by pushing the long strand <em>away<\/em>&#8230; and pulling the short strand <em>toward<\/em> the surgeon with equal tension. Note that tension is applied by pulling the two strands in opposite directions at an angle of 180 degrees.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand8\" src=\"\/surgery\/files\/2005\/04\/1hand8-400x300.jpg\" alt=\"One Hand 8\" width=\"260\" height=\"193\" \/><\/p>\n<p>8) As the second throw is initiated, the short end is toward the surgeon and is being grasped by the thumb and index finger.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand9\" src=\"\/surgery\/files\/2005\/04\/1hand9-400x300.jpg\" alt=\"One Hand 9\" width=\"260\" height=\"193\" \/><\/p>\n<p>9) The right index finger and thumb continue to grasp the short end, as the middle and ring fingers are placed behind the short end to begin creating a loop. The left hand has begun to bring the long strand toward the surgeon.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand10\" src=\"\/surgery\/files\/2005\/04\/onehand10-400x300.jpg\" alt=\"One Hand 10\" width=\"260\" height=\"193\" \/><\/p>\n<p>10) The right hand has supinated slightly &#8230;<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand11\" src=\"\/surgery\/files\/2005\/04\/onehand11-400x300.jpg\" alt=\"One Hand 11\" width=\"260\" height=\"193\" \/><\/p>\n<p>11) &#8230; as the left hand brings the long strand toward the surgeon and across the short strand to form a loop.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand12\" src=\"\/surgery\/files\/2005\/04\/onehand12-400x300.jpg\" alt=\"One Hand 12\" width=\"260\" height=\"193\" \/><\/p>\n<p>12) The right middle finger has now been flexed so it can slide behind the short strand.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand13\" src=\"\/surgery\/files\/2005\/04\/onehand13-400x300.jpg\" alt=\"One Hand 13\" width=\"260\" height=\"193\" \/><\/p>\n<p>13) The right middle finger is now behind the short strand, which is still being grasped by the thumb and index finger.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand14\" src=\"\/surgery\/files\/2005\/04\/onehand14-400x300.jpg\" alt=\"One Hand 14\" width=\"260\" height=\"193\" \/><\/p>\n<p>14) The right middle finger is now used as a lever to rotate the short end away from the surgeon.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand15\" src=\"\/surgery\/files\/2005\/04\/onehand15-400x300.jpg\" alt=\"One Hand 15\" width=\"260\" height=\"193\" \/><\/p>\n<p>15) The short ended is released by the thumb, but the ring finger pinches the short end inside the loop by squeezing it against the middle finger.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand16\" src=\"\/surgery\/files\/2005\/04\/onehand16-400x300.jpg\" alt=\"One Hand 16\" width=\"260\" height=\"193\" \/><\/p>\n<p>16) The short end is now drawn through the loop away from the surgeon by the middle and ring fingers.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand17\" src=\"\/surgery\/files\/2005\/04\/onehand17-400x300.jpg\" alt=\"One Hand 17\" width=\"260\" height=\"193\" \/><\/p>\n<p>17)<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand18\" src=\"\/surgery\/files\/2005\/04\/onehand18-400x300.jpg\" alt=\"One Hand 18\" width=\"260\" height=\"193\" \/><\/p>\n<p>18) As the short end moves through the loop, the thumb squeezes it against the middle finger.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand19\" src=\"\/surgery\/files\/2005\/04\/onehand19-400x300.jpg\" alt=\"One Hand 19\" width=\"260\" height=\"193\" \/><\/p>\n<p>19) Finally, the short end has been re-grasped with the right hand and pulled away from the surgeon as the left hand pulls the long strand to secure the second throw.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand20\" src=\"\/surgery\/files\/2005\/04\/onehand20-400x300.jpg\" alt=\"One Hand 20\" width=\"260\" height=\"193\" \/><\/p>\n<p>20) The 3rd throw is initiated in the same way as the 1st throw, by pushing the short end to the left with the right index finger.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand21\" src=\"\/surgery\/files\/2005\/04\/onehand21-400x300.jpg\" alt=\"One Hand 21\" width=\"260\" height=\"193\" \/><\/p>\n<p>21) The left hand brings the long strand to the right, beneath the short end.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand22\" src=\"\/surgery\/files\/2005\/04\/onehand22-400x300.jpg\" alt=\"One Hand 22\" width=\"260\" height=\"193\" \/><\/p>\n<p>22) The right index finger is inserted into the loop that has been created.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand23\" src=\"\/surgery\/files\/2005\/04\/onehand23-400x300.jpg\" alt=\"One Hand 23\" width=\"260\" height=\"193\" \/><\/p>\n<p>23) And the right index finger rolls behind the short end in order to rotate it up through the loop.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand24\" src=\"\/surgery\/files\/2005\/04\/onehand24-400x300.jpg\" alt=\"One Hand 24\" width=\"260\" height=\"193\" \/><\/p>\n<p>24) The short end has emerged from the loop and has been re-grasped by the right hand.<\/p>\n<hr style=\"clear: both;\" \/>\n<p><img loading=\"lazy\" class=\"alignright size-medium wp-image-1346\" title=\"onehand25\" src=\"\/surgery\/files\/2005\/04\/onehand25-400x300.jpg\" alt=\"One Hand 25\" width=\"260\" height=\"193\" \/><\/p>\n<p>25) And the 3rd throw is secured by pulling the short strand toward the surgeon, as the long strand is pulled away at an angle of 180 degrees.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>One Hand Square Knot Wayne W. LaMorte, M.D., Ph.D., M.P.H. Photography by Michael J. LaMorte Two hand ties are generally preferred by most surgeons, but one hand ties can also be used. 1) Note that the short end has been placed beneath the tubing and is held in the right hand, away from the surgeon. [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":108,"menu_order":9,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.bumc.bu.edu\/surgery\/wp-json\/wp\/v2\/pages\/113"}],"collection":[{"href":"https:\/\/www.bumc.bu.edu\/surgery\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.bumc.bu.edu\/surgery\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/surgery\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/surgery\/wp-json\/wp\/v2\/comments?post=113"}],"version-history":[{"count":12,"href":"https:\/\/www.bumc.bu.edu\/surgery\/wp-json\/wp\/v2\/pages\/113\/revisions"}],"predecessor-version":[{"id":2088,"href":"https:\/\/www.bumc.bu.edu\/surgery\/wp-json\/wp\/v2\/pages\/113\/revisions\/2088"}],"up":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/surgery\/wp-json\/wp\/v2\/pages\/108"}],"wp:attachment":[{"href":"https:\/\/www.bumc.bu.edu\/surgery\/wp-json\/wp\/v2\/media?parent=113"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}