Postoperative hand therapy management of zones V and VI extensor tendon repairs of the fingers: An international inquiry of current practice

Hirth, Melissa J.; Howell, Julianne W.; Feehan, Lynne M.; Brown, Ted; O’Brien, Lisa

doi:10.1016/j.jht.2019.12.019

Cited by 16 publications

(26 citation statements)

References 31 publications

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“…The original English-language survey administered to therapists of countries with full membership in the IFSHT 1 was sent to Malaysian therapists whose national language is Malay. To undertake the survey, therapists had to have postoperatively managed one or more zone V or VI finger extensor tendon repair(s) within the previous year and have either been a member of the MSHT or have attended a MSHT-sponsored symposium.…”

Section: Methodsmentioning

confidence: 99%

“…The survey instrument (Supplementary File 1) was designed by Occupational Therapists MJH and LO’B and Physiotherapists JWH and Lynne Feehan, each with more than 20-years practical experience in hand therapy. 1 Proficiency in survey design and implementation was contributed by Lynne Feehan, LO’B and TB. 1 Questions were constructed to investigate current preferences and practice relating to the postoperative management of zones V-VI finger extensor tendon repair, specifically to the five approaches (splint/motion program) shown in Figure 1(a) to (e).…”

Section: Methodsmentioning

confidence: 99%

“…A survey of individual members of the International Federation of Societies for Hand Therapy (IFSHT) full-member countries determined relative motion splints with early active motion as the most used approach in the postoperative management of zones V-VI extensor tendon repairs of the fingers. 1 To gain a more inclusive global perspective of therapists’ practice patterns, the authors recommended surveying therapists from non-IFSHT member countries. 1 In 2019, this opportunity presented itself, after author JWH was invited by the Malaysian Society for Hand Therapists (MSHT) to deliver a symposium on the topic of Relative Motion.…”

Section: Introductionmentioning

confidence: 99%

“…1 To gain a more inclusive global perspective of therapists’ practice patterns, the authors recommended surveying therapists from non-IFSHT member countries. 1 In 2019, this opportunity presented itself, after author JWH was invited by the Malaysian Society for Hand Therapists (MSHT) to deliver a symposium on the topic of Relative Motion. The MSHT was established in 2014, has 62 members, and is a member of the Asia Pacific Federation of Societies for Hand Therapy, an IFSHT regional liaison organisation.…”

Section: Introductionmentioning

confidence: 99%

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Postoperative management of zones V-VI extensor tendon repairs: A survey of practice in Malaysia and comparison to IFSHT member countries

et al. 2021

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Introduction A survey of International Federation of Societies for Hand Therapy (IFSHT) member countries identified relative motion extension as the preferred approach to management of zones V-VI extensor tendon repairs. The aims of this survey were to identify and compare hand therapy practice patterns in Malaysia (a non-IFSHT member country) with findings of the IFSHT survey including an IFSHT subset of Asia-Pacific therapists and to investigate if membership status of the Malaysian Society for Hand Therapists (MSHT) influenced therapy practice patterns. Methods An online English-language survey was distributed to 90 occupational therapists and physiotherapists including MSHT members and non-members. Participation required management of at least one extensor tendon repair in the preceding year. Five approaches were surveyed: immobilisation, early passive motion (EPM) with dynamic splinting, and early active motion (EAM) delivered by resting hand (RH), palmar resting interphalangeal joints free (PR), and relative motion extension (RME) splints. Results Thirty-seven of the 53 therapists (68%) who commenced the survey completed it. The most used approach was dynamic/EPM (28%), followed by RH/immobilisation (22%) and RH/EAM (22%). A preference for RME/EAM was identified with implementation barriers being surgeon preference and hand therapist confidence. Discussion Approach selection for Malaysian therapists differed from the combined IFSHT and Asia-Pacific respondents, with the former using dynamic/EPM and RH/immobilisation compared to IFSHT respondents who predominately used RME/EAM and PR/EAM. This survey provides valuable insights into Malaysian hand therapists’ practices. If implementation barriers and therapist confidence are addressed, Malaysian practice patterns may change to better align with current evidence.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Postoperative management of zones V-VI extensor tendon repairs: A survey of practice in Malaysia and comparison to IFSHT member countries

et al. 2021

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“…9 Application of the relative motion concept for management of extensor tendon repairs has been successful using the relative motion extension (RME) splint, whereby the MCPJ of the affected finger(s) is positioned in relatively more extension than the noninjured fingers. [13][14][15][16][17][18] The aims of this systematic review were to explore the published and unpublished (grey) literature and examine: (i) indications for use of a RMF splint following flexor tendon repair; (ii) reported splint designs; (iii) accompanying rehabilitation exercise programmes (including hand function); and (iv) the clinical and patient reported outcomes.…”

Section: Introductionmentioning

confidence: 99%

Relative motion flexion splinting for the rehabilitation of flexor tendon repairs: A systematic review

Newington

Ross

Howell³

2021

Hand Therapy

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Introduction Relative motion splinting has been used successfully in the treatment of extensor tendon repairs and has recently been applied in flexor tendon rehabilitation. The purpose of this systematic review was to identify articles reporting use of relative motion flexion (RMF) splinting following flexor tendon repair and to examine indications for use and clinical outcomes. Methods Seven medical databases, four trials registries and three grey literature sources were systematically searched and screened against pre-specified eligibility criteria. Screening, data extraction and quality appraisal were independently performed by two reviewers. Results A total of 12 studies were identified, of which three met the review eligibility criteria: one retrospective case series; one cadaveric proof of concept study; and one ongoing prospective case series. The type of splint (including metacarpophalangeal joint position and available movement), exercise programme, and zone of tendon injury varied between studies. Both case series presented acceptable range of movement and grip strength outcomes. The prospective series reported one tendon rupture and two tenolysis procedures; the retrospective series reported no tendon ruptures or secondary surgeries. Discussion We found limited evidence supporting the use of RMF splinting in the rehabilitation of zones I-III flexor tendon repairs. Further prospective research with larger patient cohorts is required to assess the clinical outcomes, patient reported outcomes and safety of RMF splinting in comparison to other regimes. Application of the relative motion principles to flexor tendon splinting varied across the included studies, and we suggest an operational definition of relative motion in this context.

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Use of a relative motion flexion orthosis for postoperative management of zone I/II flexor digitorum profundus repair: A retrospective consecutive case series

Henry

Howell²

2020

Journal of Hand Therapy

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Postoperative hand therapy management of zones V and VI extensor tendon repairs of the fingers: An international inquiry of current practice

Cited by 16 publications

References 31 publications

Postoperative management of zones V-VI extensor tendon repairs: A survey of practice in Malaysia and comparison to IFSHT member countries

Postoperative management of zones V-VI extensor tendon repairs: A survey of practice in Malaysia and comparison to IFSHT member countries

Relative motion flexion splinting for the rehabilitation of flexor tendon repairs: A systematic review

Use of a relative motion flexion orthosis for postoperative management of zone I/II flexor digitorum profundus repair: A retrospective consecutive case series

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