A Prospective Review of Open Central Slip Laceration Repair and Rehabilitation

Abstract

A prospective review was carried out to evaluate the outcome of surgically repaired open central slip (zone III) injuries which were treated with 3 weeks of proximal interphalangeal joint immobilization within a cylinder splint and then with 3 weeks of controlled mobilization within a Capener coil splint. Thirty-one fingers in 27 patients were assessed by the same independent therapist. All fingers achieved an excellent or good recovery with a mean proximal interphalangeal joint flexion of 94 degrees (range 70-110 degrees) and a mean distal interphalangeal joint flexion of 57 degrees (range 30-81 degrees). Extension deficits of the proximal interphalangeal joint were noted in five fingers (mean 6 degrees, range 3-15 degrees). The results show that a combination of immobilization and controlled mobilization is an effective rehabilitation regime for surgically repaired open central slip injuries.

Salter-Harris type II fracture of the middle phalanx with concomitant central slip injury in an 11 years old: a case report

“…First, management of the central slip injury requires splinting because immediate ROM may not allow adequate healing. 12 The central slip injury could have been overlooked in light of the more severe injury to the epiphysis. The desire to get patients moving to avoid stiffness could have been detrimental to the second and more subtle injury.…”

Surgical Repair of Central Slip Avulsion Injuries With Mitek Bone Anchor — Retrospective Analysis of a Case Series

“…Pratt et al described a regime of immobilisation of the PIP joint in a cylinder splint for three weeks followed by a Capener dynamic splint. 27 Several studies had shown the benefits of dynamic splinting, 23,28,29 early active mobilisation for extensor tendon, 30,31 and early active mobilisation for central slip injury. 6,7 O'Dwyer and Quinton used a combination of initial rigid splintage followed by a dynamic Capener splint starting between day 10 to day 14 and reported that 88% of patients had excellent or good results after six months.…”

Extensor Tendon Injuries

“…His 27 patients (31 fingers) demonstrated good to excellent results, but 5 fingers had extension deficits. 29 Zone IV Similar to zone II injuries, zone IV injuries are most often secondary to lacerations. Because the tendon is flat and wraps around the proximal phalanx at this level, injuries are frequently partial.…”