A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL OF CONTROLLED PASSIVE MOBILIZATION VS. PLACE AND ACTIVE HOLD EXERCISES AFTER ZONE 2 FLEXOR TENDON REPAIR

Hand Surgery ◽  
2014 ◽  
Vol 19 (01) ◽  
pp. 53-59 ◽  
Author(s):  
Maryam Farzad ◽  
Fereydoun Layeghi ◽  
Ali Asgari ◽  
David C. Ring ◽  
Masoud Karimlou ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Flexor Tendon ◽  
Controlled Trial ◽  
Tendon Repair ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Total Active Motion ◽  
Passive Mobilization

Purpose: The rehabilitation program after flexor tendon repair of zone II laceration varies. We designed a Prospective Randomized Controlled Trial of controlled passive mobilization (modified Kleinert) vs. Place and active hold exercises after zone 2-flexor tendon repair by two-strand suture (Modified kessler). Methods: Sixty-four fingers in 54 patients with zone 2 flexor tendon modified Kessler repairs were enrolled in a prospective randomized controlled trial comparing place and active hold exercises to controlled passive mobilization (modified Kleinert). The primary outcome measure was total active motion eight weeks after repair as measured by an independent and blinded therapist. Results: Patients treated with place and active hold exercises had significantly greater total active motion (146) eight weeks after surgery than patients treated with controlled passive mobilization (114) (modified Klinert). There were no ruptures in either group. Conclusions: Place and hold achieves greater motion than controlled passive mobilization after a two-strand repair for zone 2 flexor tendon repairs.

scholarly journals PXL01 in Sodium Hyaluronate for Improvement of Hand Recovery after Flexor Tendon Repair Surgery: Randomized Controlled Trial

PLoS ONE ◽  
2014 ◽  
Vol 9 (10) ◽  
pp. e110735 ◽  
Author(s):  
Monica E. Wiig ◽  
Lars B. Dahlin ◽  
Jan Fridén ◽  
Lars Hagberg ◽  
Sören E. Larsen ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Flexor Tendon ◽  
Controlled Trial ◽  
Tendon Repair ◽  
Sodium Hyaluronate ◽  
Flexor Tendon Repair ◽  
Randomized Controlled

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?

Hand Therapy ◽  
2012 ◽  
Vol 17 (2) ◽  
pp. 37-41 ◽  
Author(s):  
Paola Errera Magnani ◽  
Aline Miranda Ferreira ◽  
Eula Katucha da Silva Rodrigues ◽  
Rafael Inácio Barbosa ◽  
Nilton Mazzer ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Patient Reported Outcome ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Patient Reported ◽  
Total Active Motion

Clinical outcomes of early active mobilization following flexor tendon repair using the six-strand technique: short- and long-term evaluations

2014 ◽  
Vol 40 (3) ◽  
pp. 250-258 ◽  
Author(s):  
K. Moriya ◽  
T. Yoshizu ◽  
Y. Maki ◽  
N. Tsubokawa ◽  
H. Narisawa ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Digitorum Superficialis ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Total Active Motion ◽  
Active Mobilization ◽  
Flexor Digitorum

We evaluated the factors influencing outcomes of flexor tendon repair in 112 fingers using a six-strand suture with the Yoshizu #1 technique and early postoperative active mobilization in 101 consecutive patients. A total of 32 fingers had injuries in Zone I, 78 in Zone II, and two in Zone III. The mean follow-up period was 6 months; 16 patients (19 fingers) participated in long-term follow-up of 2 to 16 years. The total active motion was 230° SD 29°; it correlated negatively with age. The total active motion was 231° SD 28° after repair of the lacerated flexor digitorum superficialis tendon, and was 205° SD 37° after excision of the flexor digitorum superficialis tendon ends ( p = 0.0093). A total of 19 fingers showed no significant increases in total active motion more than 2 years after surgery. The rupture rate was 5.4% in our patients and related to surgeons’ level of expertise. Five out of six ruptured tendons were repaired by inexperienced surgeons. Level of Evidence IV

Primary Flexor Tendon Repair in Zones 1 and 2: Early Passive Mobilization Versus Controlled Active Motion

2014 ◽  
Vol 39 (7) ◽  
pp. 1344-1350 ◽  
Author(s):  
Florian Samuel Frueh ◽  
Viviane Sylvie Kunz ◽  
Isaac Joseph Gravestock ◽  
Leonhard Held ◽  
Mathias Haefeli ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Passive Mobilization ◽  
Early Passive

scholarly journals Active Mobilisation after Flexor Tendon Repair: Comparison of Results following Injuries in Zone 2 and other Zones

2005 ◽  
Vol 13 (2) ◽  
pp. 158-163 ◽  
Author(s):  
LK Hung ◽  
KW Pang ◽  
PLC Yeung ◽  
L Cheung ◽  
JMW Wong ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Clinical Results ◽  
Range Of Movement ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Day Range ◽  
Flexor Tendon Injuries ◽  
Total Active Motion ◽  
American Society

Purpose. To prospectively study the role of active mobilisation after flexor tendon repair. Methods. The standard modified Kessler's technique was used to repair 46 digits in 32 patients with flexor tendon injuries. Early active mobilisation of the repaired digit was commenced on the third postoperative day. Range of movement was monitored and recovery from injury in zone 2 was compared with injury in other zones. Results. There were 24 and 22 injuries in zone 2 and other zones respectively. The total active motion score of the American Society for Surgery of the Hand was measured. Patients with zone-2 injuries achieved similar results to those with other-zone injuries apart from a 3-week delay in recovery. The final results were good to excellent in 71% and 77% of zone-2 and other-zone cases respectively (p<0.05). There were 2 ruptures in zone-2 and one rupture in zone-3 repairs (6.5%). Conclusion. Preliminary results of this study showed that active mobilisation following flexor tendon repair provides comparable clinical results and is as safe as conventional mobilisation programmes although recovery in patients with zone-2 injury was delayed.

Clinical Results of Flexor Tendon Repair in Zone II Using a Six-Strand Double-Loop Technique Compared with a Two-Strand Technique

2008 ◽  
Vol 33 (4) ◽  
pp. 418-423 ◽  
Author(s):  
G. L. Hoffmann ◽  
U. Büchler ◽  
E. Vögelin
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Functional Results ◽  
Clinical Results ◽  
Rubber Band ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Flexor Tendon Injuries ◽  
Total Active Motion ◽  
Zone Ii

The clinical and functional results of 46 patients who underwent zone II flexor tendon repair using the Lim/Tsai technique combined with the Kleinert/Duran early active mobilisation regime and place and hold exercises were assessed. The results were compared with 25 patients who were treated by the modified Kessler technique and the Kleinert/Duran regime alone. After a follow-up of 8 to 17 weeks, the Lim/Tsai group had a better grip strength and a significantly better total active motion of 141° compared with 123°. The rupture rates (Lim/Tsai: 1/51; Kessler: 3/26) and the extension deficits were not statistically different in the two groups. However, the complication rate was significantly lower and the average time of treatment was significantly shorter in the Lim/Tsai group. These results support the use of the Lim/Tsai six-strand repair technique in zone II flexor tendon injuries and early active mobilisation without rubber-band traction.

scholarly journals Efficacy of the Manchester Short Splint versus traditional dorsal splint for rehabilitation of Zone II flexor tendon repairs: study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
Vivien Lees ◽  
Denise O'Brien ◽  
Karen Redvers-Chubb
Keyword(s):  
Randomized Controlled Trial ◽  
Flexor Tendon ◽  
Controlled Trial ◽  
Tendon Repair ◽  
Trial Registration ◽  
Data Set ◽  
Multi Centre Study ◽  
Randomized Controlled ◽  
Patient Reported ◽  
Zone Ii

Abstract Background: A previously reported audit of use of the Manchester Short Splint versus the traditional long dorsal forearm splint for rehabilitation of zone II flexor tendon repairs suggested that patient outcomes were enhanced by use of the short splint. Specifically, there was less flexion contracture at the proximal interphalangeal joints at 6 and 12 weeks with greater final range of motion (Strickland assessment). Importantly, there was no evidence of excess tendon ruptures complicating use of the short splint.Methods: The present study is designed as a single-centre randomized controlled trial to compare the two splints [Clinical Evidence Level 2 as patient and treating therapists are aware of which splint is in use]. The study is framed to demonstrate superiority of the short splint intervention over the long splint. Surgery is standardized with respect to the type of repair used. Inclusion criteria for the trial include single finger flexor tendon injury of zone II with up to one but not two simultaneous digital nerve injuries operated on within 4 days of the injury date. Exclusions include children, more complex injuries, those unable to give consent or otherwise co-operate with the trial protocol. Patients are recruited at their first hand therapy visit having been provided with information about the trial by one of the Site Investigators during their hospital admission. The consenting patient is randomized into one of two splint groups. Assessments at 6 and 12 weeks include range of interphalangeal joint motion (TAM), patient reported outcomes (PEM, Quick Dash, pain scales) and grip strength (12 weeks only). Adverse events related and unrelated are documented in line with GCP protocols and patients managed according to clinical indications.Discussion: The present study aims to determine the efficacy of the short splint versus the traditional splint in rehabilitation of Zone II flexor tendon repair. Previous work was in the form of an audit and it is clearly desirable that a more rigorous study is undertaken to address the efficacy or otherwise of the short splint in the context of a clinical trial and to inform development of a multi-centre study.Trial registration: ClinicalTrials.gov Identifier: NCT0385021021.2.19 Retrospectively registeredhttps://clinicaltrials.gov/ct2/results?cond=&term=NCT03850210&cntry=&state=&city=&dist= See website for WHO Trial Registration Data SetTrial Status: Recruitment of first patient 31.3.15. Recruitment completed 6.4.20 subsequent to first submission of manuscript 3.4.20. Study is ongoing for subsequent patient review and measurements as protocol for the subsequent 12 week period and will conclude 29.6.20.

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