Postoperative Management of Extensor Pollicis Longus Repairs within Close Vicinity to or within the Extensor Retinaculum

Chinchalkar, Shrikant J.; Pipicelli, Joey G.; Laxamana, Joan; Dehn, Leslie von

doi:10.1016/j.jht.2009.11.006

Cited by 3 publications

(9 citation statements)

References 18 publications

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“…The primary function of EPL is IP joint hyperextension, and by positioning the IP joint in hyperextension within the splint, tension is relieved from the distal aspect on the repair itself in zone T II. The tendon repair is also protected proximally through insertions of the abductor pollicis brevis, flexor pollicis brevis and adductor pollicis brevis onto the EPL itself forming the 4,6,7 Given these structures are all intrinsic muscles and are retaining EPL preventing its retraction, it is unnecessary to include the wrist in the splint for postoperative protection. Essentially, the case series' focus was on reviewing EPL function (namely IP joint hyperextension), following use of a hand-based splint rather than on regaining full range into flexion.…”

Section: Discussionmentioning

confidence: 99%

“…Although there is a high prevalence of EPL injury, the literature on clinical rehabilitation studies of EPL repairs following trauma is small [3][4][5] and rarely discussed in isolation from the finger extensors. 3,5 There is also limited recent literature specifically investigating splinting options for zone T II EPL tendon repairs.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6][7][8][9] Various factors for suitability of an EAM regimen are considered in the clinical reasoning process, including repairs compromised by infection, fragile repair as stated by the surgeon, compliance of the patient and experience of the therapist.…”

Section: Introductionmentioning

confidence: 99%

“…The majority of the existing literature regarding EPL tendon rehabilitation consists predominantly of clinical outcomes for dynamic splinting combined with controlled passive motion protocols, 5,9,[10][11][12] and two papers on EAM. 3,4 Both versions implemented a forearm-based splint, with little discussion on variation of splint design.…”

Section: Introductionmentioning

confidence: 99%

“…4 Following a laceration, this expansion prevents proximal migration of the EPL, with the sagittal bands having a similar effect to extensor digitorum communis of the finger. 1 Jaibaji et al 13 investigated the functional anatomy of the thumb sagittal band using 24 cadaveric amputated specimens.…”

Section: Introductionmentioning

confidence: 99%

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Retrospective review of hand-based splinting for zone II extensor pollicis longus tendon repairs using an early active motion rehabilitation regimen

Veenendaal

Moate

2011

Hand Therapy

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Introduction. Forearm-based splints have been traditionally used for extensor pollicis longus (EPL) tendon repairs for zones T II-T V (T is used to represent thumb extensor tendon zones). Limited literature exists on hand-based splinting in the rehabilitation of zone T II EPL tendon repairs. This retrospective review of five case studies highlights the anatomical justification and the outcome of rehabilitation of zone T II EPL surgical repairs using a static hand-based thumb extension splint. Methods. In this study, five patients were retrospectively reviewed. All patients attended hand therapy for initial treatment within three days postoperatively. The postoperative interphalangeal joint mobilization regimen utilized in this study was early active motion (EAM). Outcomes measured in the study were reliable and valid, including goniometry measurement at week 4, week 6 and week 8 postoperatively for range of motion, total active motion (TAM), Dargan's criteria assessing extensor lag and White's assessment of interphalangeal joint range of motion. Results. The results demonstrated that a hand-based splint did not create undue stress on the EPL tendon repair, as there was no incidence of rupture. Hyperextension of EPL was within 88 compared with the noninjured thumb. 'Excellent' and 'good' categories were achieved when applying TAM criteria, White's assessment and Dargan's criteria. Conclusion. A hand-based splint with an EAM regimen is a viable treatment option for zone T II EPL surgical repairs instead of a long forearm-based splint. Further research is warranted with a larger sample and using a control group.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Retrospective review of hand-based splinting for zone II extensor pollicis longus tendon repairs using an early active motion rehabilitation regimen

Veenendaal

Moate

2011

Hand Therapy

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Verletzungen der Strecksehnen

Breier¹,

Beiträgen²,

Behrendt³

2013

Handrehabilitation

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Comparison of impairment and restitution of hand function in a group of patients with total damage to the extensor pollicis longus and in a group of patients with damage to the flexor pollicis longus tendon after surgical treatment

Szczechowicz

Jamka²,

Pieniążek

2016

Med Rehabil

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The thumb constitutes 40% of the whole hand function, and damage to the extensor pollicis longus (EPL) and/or the flexor pollicis longus (FPL) tendons of the thumb results in its significant limitation. The main factors contributing to damage of the EPL and/or FPL tendons are mechanical injuries - cuts and spontaneous ruptures. The aim of the study was to compare values of thumb and whole hand function loss and restoration as a result of the implemented physical therapy in patients with total damage to the EPL tendon with the values obtained by the study group 2 comprised of patients with damage to the FPL tendon. The study involved 25 patients of the Specialized Hand Therapy Center in Krakow. 15 of them had ruptured continuity of the EPL tendon (study group), and 10 suffered damage to the FPL tendons (control group). The study included measurements of active motion of the thumb and wrist and superficial sensation. On the basis of these tests, functional impairment was measured using the methodology according to Swanson. The study included assessment of muscle strength in terms of global and precision grips using a dynamometer. Statistically signifcant functional improvement was noted for the thumb and whole hand as well as muscle strength in both groups. The values of functional loss differed between the two groups. The indicators of functional improvement were greater in patients with damage to the EPL tendon. Functional physical therapy is an important factor determining the return of function in the thumb and whole hand after total damage to the EPL and FPL tendons. Szczechowicz J., Jamka K., Pieniążek M. Comparison of impairment and restitution of hand function in a group of patients with total damage to the extensor pollicis longus and in a group of patients with damage to the flexor pollicis longus tendon after surgical treatment. Med Rehabil 2016; 20(3): 5-12. DOI: 10.5604/01.3001.0009.5009

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Postoperative Management of Extensor Pollicis Longus Repairs within Close Vicinity to or within the Extensor Retinaculum

Cited by 3 publications

References 18 publications

Retrospective review of hand-based splinting for zone II extensor pollicis longus tendon repairs using an early active motion rehabilitation regimen

Retrospective review of hand-based splinting for zone II extensor pollicis longus tendon repairs using an early active motion rehabilitation regimen

Verletzungen der Strecksehnen

Comparison of impairment and restitution of hand function in a group of patients with total damage to the extensor pollicis longus and in a group of patients with damage to the flexor pollicis longus tendon after surgical treatment

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