Extensor Tendon Rehabilitation a Prospective Trial Comparing Three Rehabilitation Regimes

Abstract

Forty-two patients with 46 complete extensor tendon injuries were prospectively allocated to one of three rehabilitation regimes: static splintage; interphalangeal joint mobilization with metacarpophalangeal joint immobilization or; the "Norwich" regime. All 42 patients were operated on by one surgeon and assessed by one hand therapist. At 4 weeks the total active motion in the static splintage group was significantly reduced but by 12 weeks there was no difference between the regimes. There was no difference in total active motion between the repaired and uninjured hand at 12 weeks, with all patients achieving good or excellent results. However, grip strength at 12 weeks was significantly reduced compared to the uninjured hand after static splintage. There was no difference in hand therapy input between the regimes.

Extensor Tendon Injuries

“…Bulstrode et al also compared static immobilization with interphalangeal joint and MCP joint active mobilization after repair of zone V and VI lacerations. 8 Similar to Mowlavi, they found that both active mobilization groups demonstrated increased TAM at 4 weeks (p Ͻ .01) but that no significant differences could be found at 3 months. 8 In a randomized, controlled study in 2000, Khandwala compared dynamic active mobilization with active mobilization in zone V and VI extensor tendon repairs.…”

“…8 Similar to Mowlavi, they found that both active mobilization groups demonstrated increased TAM at 4 weeks (p Ͻ .01) but that no significant differences could be found at 3 months. 8 In a randomized, controlled study in 2000, Khandwala compared dynamic active mobilization with active mobilization in zone V and VI extensor tendon repairs. Each group had 50 patients, but no statistical differences in TAM could be found.…”

Comparison of Therapeutic Activities With Therapeutic Exercises in the Rehabilitation of Young Adult Patients With Hand Injuries

“…[3][4][5] Static or dynamic splinting and early active or early passive mobilization have been investigated. [1][2][3][4][5][6][7][8][9][10][11][12][13] The evidence regarding the best mobilization strategy is insufficient. 2 In later stages of rehabilitation, protocols of progressive loading exercises against a gradually increasing resistance might be added.…”

Tendon Injuries in the Pediatric Hand

“…37 Early active mobilization within the constraints of a thermoplastic splint (Norwich regimen) in which the wrist was immobilized at 45 degrees of extension, the MP joints in at least 50 degrees of flexion and the interphalangeal joints in neutral, have also been shown to give good results in zones V and VI injuries with a TAM of 160 degrees after 4 weeks. 38 Zones I and II injuries (mallet finger injuries) are treated by full immobilization. 37 and it limits tendon gliding within fibrous synovial sheaths.…”