Is there a correlation between patient-reported outcome assessed by the Disabilities of the Arm, Shoulder and Hand Questionnaire and total active motion after flexor tendon repair?

Magnani, Paola; Ferreira, Aline Miranda; Rodrigues, Edson; Barbosa, Rafael Inácio; Mazzer, Nílton; Elui, Valéria Meirelles Carril; Fonseca, Marisa de Cássia Registro

doi:10.1258/ht.2012.012005

Cited by 4 publications

(2 citation statements)

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“…28 Diminished TAM values have been cited as one of the factors related to reduced grip force 8 and function. 29 In this study, 65% of the fingers were classified as regular or poor in the injured group, at the time of evaluation, between 8 and 10 weeks postoperation. Bal et al 6 analyzed subjects with flexor tendons injuries in zone V after 55 weeks postoperation, using the modified Kleinert protocol.…”

Section: Discussionmentioning

confidence: 92%

Should we think about wrist extensor after flexor tendon repair?

et al. 2013

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Objective:To evaluate the activity of wrist extensor muscle, correlating with wrist motion during gripping after flexor tendon repair.Design:Cross-sectional clinical measurement study.Setting:Laboratory for biomechanics and rehabilitation.Subjects:A total of 11 patients submitted to rehabilitation by early passive motion of the fingers with wrist flexion position were evaluated after 8 weeks of fingers flexor tendon repair and 11 healthy volunteers, all ranging from 20 to 37 years of age.Intervention:Volunteers performed an isometric standardized gripping task.Main measures:We used electrogoniometry to analyze wrist range of motion and surface electromyography, considering 100% maximum voluntary contraction to represent the amplitude of electromyographic activity of the extensor carpi radialis and flexor digitorum superficialis.Results:Patients with flexor tendon repair showed co-activation deficit between wrist extensor (extensor carpi radialis) and flexor finger muscles (flexor digitorum superficialis) during gripping in the intermediate phase of rehabilitation, despite some recovering mobility for wrist extension (p ≤ 0.05). A moderate correlation between range of motion and extensor carpi radialis was present only for injured group (r = 0.32). Total active motion score, which represents finger active excursion, was regular or poor in 65% of cases, all with nerve repair associated.Conclusion:Wrist extensors have an important synergist role at handgrip, although some imbalance can be present after flexor tendon repair. These preliminary findings suggest that emphasis could be directed to add synergistic wrist motion in rehabilitation protocols after flexor tendon repair. Future studies with early active rehabilitation are necessary.

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Section: Discussionmentioning

confidence: 92%

Should we think about wrist extensor after flexor tendon repair?

et al. 2013

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“…Outcome assessment of a multicomponent flexor tendon injury in zone V should capture the integrity of hand function. 16 Other factors that influence the outcome of flexor tendon repair are surgical technique, immobilization period, and postoperative rehabilitation protocol. 17 Our review highlights Noaman's Criteria as being one of its kind developed solely for spaghetti wrist, and its lack of extensive use in the recent literature even though it involves wholesome evaluation of the tendon function, motor function of median and ulnar nerves, deformity, and sensations along with the ROM assessment.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Outcome Measures of Zone V Flexor Tendon Injury: A Systematic Review

Cardoz Lobo,

Manek,

Bhosale

et al. 2023

Indian J Plast Surg

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Background Flexor tendon injury zone V is a multicomponent soft tissue injury involving tendons, nerves, and vessels. Outcome assessment of repair thus requires evaluation of the hand as a whole rather than solely evaluating tendon function. The purpose of this Preferred Reporting Items for Systematic Reviews and Meta-Analyses -compliant systematic review was to identify and assess the components of outcome measures used in flexor zone V. Methods A total of 3,761 studies were retrieved from four databases (PubMed, ProQuest, Cochrane Central, and Google Scholar). These studies were then screened for inclusion using a validated screening form. Fifteen articles fulfilling the eligibility criteria were included in the review. Subsequently, the included studies were assessed for methodological quality using the Joanna Brigg Institute tool. Results Out of the 15 studies, 11 were case series, 3 were cross-sectional studies, and 1 was a randomized controlled trial. Out of 15 included studies, 13 were of low risk, whereas 2 studies suggested moderate risk when assessed for methodological quality using the Joanna Brigg Institute tool. Eight outcome measures were identified, out of which the most frequently used were Total Active Motion by the American Society for Surgery of Hand (TAM-ASSH) and Noaman's criteria. Our study found that Noaman's criteria assessed sensory-motor function and finger deformity in addition to the range of motion (ROM), which was found to be assessed by all the other outcome measures. Conclusion We concluded that although Buck-Gramcko criteria is well suited for the ROM evaluation, Noaman's criteria, a recently developed outcome measure used exclusively for combined injuries in zone V, took into consideration the implications of nerve injury along with tendon function. Although being specifically designed for combined injuries of tendons, nerves, and vessels in zone V, there is a lack of usage of Noaman's in the literature. There still exists a lack of a consistent and appropriate choice of outcome measure.

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