Infocenter

The Outback Knot

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Step 1		Step 2		Step 3
The knot is started with the post hand ( white strand ) held between the ring and small finger with a clamp to aid in holding the short end of the suture		The post strand is placed over the thumb		The non-post strand in the right hand is brought over the thumb and the post hand thumb and index finger are brought together
Step 4		Step 5		Step 6
The post hand index and thumb bring the free strand through to tie a simple knot		The index and long finger of the post hand grasp the white strand to cross the two strands. The wrist is supinated to assist this manoeuver		The blue strand (non-post) is presented to the index and long finger
Step 7		Step 8		Step 9
The index and long finger pull the blue strand through		The loose blue strand is passed through the hole near the thumb with two strands of suture on the right of the thumb and one on the left from the surgeons perspective		The suture is pulled through with the right hand and the loop is then allowed to slip off the thumb of the left hand
Step 10		Step 11		Step 12
The knot is pulled into the joint with the post hand assisted with a knot pusher as necessary. Note that the knot is kept loose and not dressed nearly to prevent premature locking		The knot is manipulated into the joint to snug the knot down on the tissue. Note that the free strand is not held with the non-post hand		The knot is locked by pulling on the free non-post limb. The locking can be seen and felt. Two or three alternating half hitches are usually added to backup the knot.
The Final Knot