Extensor Tendon Rehabilitation a Prospective Trial Comparing Three Rehabilitation Regimes

2005 ◽  
Vol 30 (2) ◽  
pp. 175-179 ◽  
Author(s):  
N. W. BULSTRODE ◽  
N. BURR ◽  
A. L. PRATT ◽  
A. O. GROBBELAAR
Keyword(s):  
Prospective Trial ◽  
Extensor Tendon ◽  
Metacarpophalangeal Joint ◽  
Tendon Injuries ◽  
Interphalangeal Joint ◽  
Hand Therapy ◽  
Active Motion ◽  
Joint Mobilization ◽  
Total Active Motion ◽  
Extensor Tendon Injuries

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.

Complex Extensor Tendon Injuries: Early Active Motion Following Single-Stage Reconstruction

2008 ◽  
Vol 33 (6) ◽  
pp. 753-759 ◽  
Author(s):  
A. R. KOUL ◽  
R. K. PATIL ◽  
V. PHILIP
Keyword(s):  
Extensor Tendon ◽  
Early Postoperative Period ◽  
Tendon Injuries ◽  
Single Stage ◽  
Retrospective Evaluation ◽  
Cost Of Treatment ◽  
Active Motion ◽  
Normal Hand ◽  
Total Active Motion ◽  
Extensor Tendon Injuries

This study presents a retrospective evaluation of patients managed with single-stage repair following complex extensor tendon injuries. Over a 2-year period, 21 extensor tendons were reconstructed in 18 patients with complex hand injuries in zones V–VII. All eight patients needed soft tissue cover. Active mobilisation was started in the first week. Total active motion (TAM) at 4 weeks was a mean of 159° (SD 21.57) and at 6 weeks it was 202.6° (SD 13.26). Average TAM at 8 weeks was 223.8° (SD 16.46) and 249.5° (SD 14.38) at 12 weeks. Grip strength at 12 weeks and 6 months was around 75% and 90% of the contralateral normal hand in most of the patients. Single-stage reconstruction of complex extensor tendon injuries seems to reduce morbidity in terms of hospitalisation, and reduced cost of treatment. It also helps to achieve better functional outcome in the early postoperative period.

Dynamic Splinting After Extensor Tendon Repair in Zones V to VII

2003 ◽  
Vol 28 (3) ◽  
pp. 224-227 ◽  
Author(s):  
S. BRÜNER ◽  
M. WITTEMANN ◽  
A. JESTER ◽  
K. BLUMENTHAL ◽  
G. GERMANN
Keyword(s):  
Retrospective Study ◽  
Surgical Complication ◽  
Tendon Repair ◽  
Extensor Tendon ◽  
Tendon Injuries ◽  
Active Motion ◽  
Evaluation Systems ◽  
Dynamic Splinting ◽  
Extensor Tendon Injuries

This retrospective study evaluates a dynamic active motion protocol for extensor tendon repairs in zones V to VII. Fifty-eight patients with 87 extensor tendon injuries were examined. Using Geldmacher’s and Kleinert and Verdan’s evaluation systems, the results were graded as “excellent” and “good” in more than 94%, and as “satisfactory” in the remainder. The need for secondary tenolysis was low (6%), and no other surgical complication occurred.

Extensor Tendon Injuries at the Proximal Interphalangeal Joint

Hand Clinics ◽  
1988 ◽  
Vol 4 (1) ◽  
pp. 25-37
Author(s):  
John A. Froehlich ◽  
Edward Akelman ◽  
James H. Herndon
Keyword(s):  
Extensor Tendon ◽  
Proximal Interphalangeal Joint ◽  
Tendon Injuries ◽  
Interphalangeal Joint ◽  
Extensor Tendon Injuries

Outcome of primary tendon grafts for open Zone 3 extensor tendon injuries

2020 ◽  
Vol 45 (10) ◽  
pp. 1045-1050
Author(s):  
Jeff Ecker ◽  
Courtney Andrijich ◽  
Karolina Pavleski ◽  
Nicole Badur ◽  
Bruno E. Crepaldi
Keyword(s):  
Extensor Tendon ◽  
Tendon Graft ◽  
Proximal Interphalangeal Joint ◽  
Tendon Injuries ◽  
Interphalangeal Joint ◽  
Level Of Evidence ◽  
Wound Excision ◽  
Poor Outcomes ◽  
Open Injuries ◽  
Extensor Tendon Injuries

Open injuries of the extensor mechanism in Zone 3 (dorsum of the proximal interphalangeal joint) have poor outcomes. We retrospectively analysed the outcomes of treating 19 Zone 3 extensor tendon injuries in 17 patients. The treatment comprised wound excision and debridement, primary tendon graft to reconstruct the damaged/missing extensor tendon, skeletal fixation when required, local flaps to vascularize the zone of injury and immediate short arc motion therapy. Using the criteria defined by Geldmacher et al., the outcome was predicted to be poor in nine, satisfactory in seven and good in three cases. In this study the outcomes were excellent in 10, good in six and satisfactory in three cases. Mean range of motion was 75° (range 25°–115°) at the proximal interphalangeal joint. We conclude that using the protocol described there should no longer be the perception of a dismal outcome for these complex Zone 3 extensor tendon injuries. Level of evidence: IV

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

Hand Therapy ◽  
2011 ◽  
Vol 16 (4) ◽  
pp. 95-101 ◽  
Author(s):  
Penelope M van Veenendaal ◽  
Fiona A Moate
Keyword(s):  
Range Of Motion ◽  
Retrospective Review ◽  
Tendon Repair ◽  
Extensor Tendon ◽  
Interphalangeal Joint ◽  
Control Group ◽  
Active Motion ◽  
Extensor Pollicis Longus ◽  
Total Active Motion ◽  
Joint Range

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 8° compared with the non-injured 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.

K-Wire Fixation for Extraarticular Transverse/Short Oblique Fractures of the Shaft of the Middle Phalanx Associated with Extensor Tendon Injury

2008 ◽  
Vol 33 (5) ◽  
pp. 561-565 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Extensor Tendon ◽  
Tendon Injury ◽  
Interphalangeal Joint ◽  
Middle Phalanx ◽  
Distal Interphalangeal Joint ◽  
Active Motion ◽  
Total Active Motion ◽  
Distal Interphalangeal ◽  
A Prospective Study

In a prospective study, 22 cases of extraarticular transverse/short oblique fractures of the shaft of the middle phalanx associated with extensor tendon injury had fixation of the fracture as well as immobilisation of the distal interphalangeal joint using a K-wire. Mobilisation of the proximal interphalangeal and metacarpophalangeal joints was started immediately after surgery. The wires were removed after 6 weeks. No post-operative complications were noted. At final follow-up (mean = 15 weeks, range = 12–24 weeks), 18 of 22 patients obtained excellent and good total active motion (TAM) scores. Stiffness was confined to the distal interphalangeal joint, and hence when the results were re-analysed for motion at that joint only, only 11 patients had excellent and good outcomes.

Hand therapy, rehabilitation, and rehabilitation following tendon injury

2021 ◽  
pp. 393-402
Author(s):  
Fiona Peck
Keyword(s):  
Extensor Tendon ◽  
Tendon Injury ◽  
Tendon Injuries ◽  
Hand Therapy ◽  
Extensor Tendon Injuries

This chapter describes the principles and techniques applied by hand therapists in the management of hand conditions in general and specific details about protocols for rehabilitation of flexor and extensor tendon injuries.

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