Comparative study between early active and passive rehabilitation protocols following two-strand flexor tendon repair: can two-strand flexor tendon repair withstands early active rehabilitation?

Sabour, Hala M Abdel; Labib, Amir; Sallam, Ahmed; Elbanna, Mohey

doi:10.4103/err.err_15_18

Cited by 3 publications

(3 citation statements)

References 20 publications

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“…[4][5][6] The rehabilitation postsurgery has a function to prevent tendon adhesion and improve the gliding movement, even tough, if the rehabilitation managed too aggressively, the postrepair tendon has tendency to rupture or become stiff. [7][8][9] Addressing injury in zone II flexor tendon may also become problematic, it needs to sustain the anatomic connection between flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) tendon. FDS tendon has two slips that it has to roll around the FDP tendon, to permit FDP pass through FDS and lie down in the superficial champers chiasma.…”

Section: Introductionmentioning

confidence: 99%

Early or delay? The most suitable rehabilitation protocol for “no man's land” injury: Meta-analysis with trial sequential analysis—20 years trends

Setiawan

Karna

Sutheno

et al. 2023

Journal of Orthopaedics, Trauma and Rehabilitation

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Objective: The aim of this study is to analyze various rehabilitation protocol and determine which methods will yield a better outcome. Methods: The database reports were searched within 1990 until 2020, using PubMed, Cochrane library database, Ovid, Medline, and the other several published trials. A statistical analysis was made from Review Manager and Trial Sequential Analysis (TSA). Result: The mean of rerupture rate is 3.3% (n = 8) in the combination protocol and 8% (n = 48) in controlled active motion (CAM) protocol. Meta-analysis found no significant difference between Kleinert versus CAM in rerupture rate. Furhtermore, we found no significant difference in Duran versus CAM in rerupture rate. In TSA, the Z-curve does not cross both of the trial sequential boundaries, a further trial with larger sample will be required. The TSA of flexion contracture CAM versus Kleinert was indicated that CAM protocol may be superior than Kleinert to reduce the incidence of flexion contracture with the range of mean flexion contracture 6.6% (n = 18) in CAM to 23.6% (n = 76) in Kleinert protocol. Conclusion: Current meta-analysis proposed that the combination technique will result less rerupture incidence and better functional outcome in flexor zone II injuries than other techniques. The CAM method also results in less flexion contracture than others. However, a further meta-analysis with larger sample trials seems to be required to confirm this review's conclusion.

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Section: Introductionmentioning

confidence: 99%

Early or delay? The most suitable rehabilitation protocol for “no man's land” injury: Meta-analysis with trial sequential analysis—20 years trends

Setiawan

Karna

Sutheno

et al. 2023

Journal of Orthopaedics, Trauma and Rehabilitation

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“… 4 5 6 The rehabilitation post-surgery has a function to prevent tendon adhesion and improve the gliding movement, even tough, if the rehabilitation managed too aggressively, the post-repair tendon has tendency to rupture or stiff. 7 8 9 Addressing injury in zone II flexor tendon may also become problematic, it needs to sustain the anatomic connection between FDS and FDP tendon. FDS tendon has two slips that it has to roll around the FDP tendon, to permit FDP pass through FDS and lie down in the superficial champers chiasma.…”

Section: Introductionmentioning

confidence: 99%

“… 4 5 6 A reabilitação pós-operatória tem a função de prevenir a adesão do tendão e melhorar o movimento de deslizamento, porém, se a reabilitação for administrada de forma muito agressiva, o tendão pós-reparo tem tendência a romper ou enrijecer. 7 8 9 Abordar a lesão no tendão flexor da zona II também pode se tornar problemático, pois precisa sustentar a conexão anatômica entre o tendão FDS e FDP. O tendão FDS tem duas cunhas que devem rolar ao redor do tendão FDP, para permitir que o FDP passe através do FDS e se deite no quiasma superficial de Champers.…”

Section: Introductionunclassified

Precoce ou tardio? O protocolo de reabilitação mais adequado para lesão na região ‘terra de ninguém’: Metanálise com análise sequencial de ensaios – Tendências de 20 anos

Setiawan,

Karna

2023

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo O objetivo deste estudo é analisar vários protocolos de reabilitação e determinar quais métodos produzem um melhor resultado. Métodos Os relatórios dos bancos de dados foram pesquisados entre 1990 e 2020, usando PubMed, banco de dados da biblioteca Cochrane, Ovid, Medline e vários outros ensaios publicados. Uma análise estatística foi feita a partir do Review Manager e Trial Sequential Analysis (TSA). Resultado A taxa média de re-ruptura é de 3,3% (n = 8) no protocolo combinado, e até 8% (n = 48) no protocolo de Movimento Ativo Controlado (MAC). As metanálises não encontraram diferença significativa entre Kleinert vs MAC na taxa de re-ruptura. Também não há diferença significativa entre Duran e MAC na taxa de re-ruptura. Na Trial Sequential Analysis (TSA), a curva z não cruza ambos os limites sequenciais de ensaio, será necessário um ensaio adicional com amostra maior. A TSA de contratura em flexão MAC vs Kleinert indicou que o protocolo MAC pode ser superior ao Kleinert para reduzir a incidência de contratura em flexão. Para a faixa de contratura média em flexão de 6,6% (n = 18) no MAC a 23,6% (n = 76) no protocolo Kleinert. Conclusão A metanálise atual propôs que a técnica combinada resultará em menor incidência de re-ruptura e melhor resultado funcional em lesões da zona flexora II do que outras técnicas. O método MAC também resulta em menos contratura em flexão do que outros. No entanto, serão necessárias mais metanálises com estudos com amostras maiores para confirmar a conclusão desta revisão.

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Rehabilitation following surgery for flexor tendon injuries of the hand

Peters

Jha

Ross

2021

Cochrane Database of Systematic Reviews

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Comparative study between early active and passive rehabilitation protocols following two-strand flexor tendon repair: can two-strand flexor tendon repair withstands early active rehabilitation?

Cited by 3 publications

References 20 publications

Early or delay? The most suitable rehabilitation protocol for “no man's land” injury: Meta-analysis with trial sequential analysis—20 years trends

Early or delay? The most suitable rehabilitation protocol for “no man's land” injury: Meta-analysis with trial sequential analysis—20 years trends

Precoce ou tardio? O protocolo de reabilitação mais adequado para lesão na região ‘terra de ninguém’: Metanálise com análise sequencial de ensaios – Tendências de 20 anos

Rehabilitation following surgery for flexor tendon injuries of the hand

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