Early active mobilisation versus immobilisation after extrinsic extensor tendon repair: A prospective randomised trial

Patil R. K.; Koul A. R.

doi:10.4103/0970-0358.96576

Indian Journal of Plastic Surgery, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Indian J Plast Surg 2012; 45(01): 029-037
DOI: 10.4103/0970-0358.96576

Original Article

Association of Plastic Surgeons of India

Early active mobilisation versus immobilisation after extrinsic extensor tendon repair: A prospective randomised trial

Autor*innen

Patil R. K.

Department of Plastic and Reconstructive surgery, Medical Trust Hospital, Cochin, Kerala, India
Koul A. R.

Department of Plastic and Reconstructive surgery, Medical Trust Hospital, Cochin, Kerala, India

Abstract

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ABSTRACT

Background: Whether to splint the extensor tendon repairs or to mobilise them early is debatable. Recently, mobilisation has shown favourable results in a few studies. This study was aimed to compare the two favoured protocols (immobilisation vs. early active motion) in Indian population. Patients and Methods: Between June 2005 and June 2007, patients with extensor tendon injuries in zones V-VIII were randomly distributed in two groups: Group A, early active motion; and group B, immobilisation. Their results at 8 and 12 weeks and 6 months were compared. Results: Patients in early active motion group were found to have better total active motion and early return to work. This difference was statistically significant up to 12 weeks, but not at 6 months. Conclusion: Early active motion following extensor tendon repair hastens patients′ recovery and helps patients to gain complete range of motion at earlier postoperative period. With improved grip strength, the early return to work is facilitated, though these advantages are not sustained statistically significantly over long term.

KEY WORDS

Early active mobilisation following extensor tendon repair - early active mobilization - extensor tendon injuries - static splinting of extensor tendons

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Referenzen

1 Green DP, Rowland SA. Fractures and dislocations in the hand. In Rockwood CA, Green DP, editors. Fractures in adults. 3 rd ed. Philadelphia: JB Lippincott; 1975. p. 225-73.
2 Clarkson P, Pelly A. The general and plastic surgery of the hand. Oxford: Blackwell Scientific Publications; 1962. P. 147-93.
3 Miller H. Repair of severed tendons of the hand and wrist: statistical analysis of 300 cases. Surg Gynecol Obstet 1942;75:693-8.
4 Koch SL. Nerve and tendon injuries. J Am Coll Surg 1943;28:125-6.
5 Bunnell S. Surgery of the hand. 2 nd ed. Philadelphia: JB Lippincott; 1948. p. 340-6.
6 Boyes JH. Intrisic muscles of fingers. In, Bunnell S, editor. Surgery of the hand. 4 th ed. Philadelphia: JB Lippincott; 1964.
7 Couch JH. The principles of tendon suture in hands. Can Med Assoc J 1939;41:27-30.
8 Dargan EL. Management of extensor tendon injuries of the hand. Surg Gynecol Obstet 1969;128:1269-73.
9 Stuart D, Zambia L. Duration of splinting after repair of extensor tendons in the hand. J Bone Joint Surg 1965;47B:72-9.
10 Doyle JR. Extensor tendon- acute injuries. In, Green DP, editor. Operative hand surgery, 2 nd ed. New York: Churchill Livingston; 1988. p. 2045-72.
11 Elliot RA. Extensor tendon repair. In, McCarthy JG, editor. Plastic surgery of the hand. 7 Philadelphia: WB Saunders Company; 1990; p. 4565-92.
12 Sylaidis P, Youatt M, Logan A. Early active mobilization for extensor tendon injuries. J Hand Surg 1997;22B:5:594-6.
13 Hung LK, Chan A, Chang J, Tasng A, Leung PC. Early controlled active mobilisation with dynamic splintage for treatment of extensor tendon injuries. J Hand Surg 1990;15A:251-7.
14 Saldana MJ, Choban S, Westerbeck LP, Schacherer TG. Results of acute zone III extensor tendon injuries treated with dynamic extension splinting. J Hand Surg 1991;16A:77-80.
15 Guinard D, Lantuejoul JP, Gerard PH, Moutet F. Mobilization precoce protégée par appareillage de levame après reparation primaire des tendons extensurs de la main. Ann Chir Main 1993;12:342-51.
16 Ip WY, Chow SP. Results of dynamic splintage following extensor tendon repair. J Hand Surg 1997;22B:283-7.
17 Kerr CD, Burczak JR. Dynamic traction after extensor tendon repair in zones 6, 7 and 8: A retrospective study. J Hand Surg 1989;14B:21-2.
18 Khandwala AR, Webb J, Harris SB, Foster AJ, Elliot D. A comparison of dynamic extension splinting and controlled active mobilization of complete divisions of extensor tendons in Zones 5 and 6. J Hand Surg 2000;25B:140-6.
19 Mowlavi A, Burns M, Brown RE. Dynamic versus static splinting of simple zone V and zone VI extensor tendon repairs: A prospective, Randomized, controlled study. Plast Reconstr Surg 2005;115:482-7.
20 Evans RB. Immediate short arc motion following extensor tendon repair. Hand Clin 1995;11:483-510.
21 Minamikawa Y, Peimer CA, Yamaguchi T, Banasiak NA, Kambe K, Sherwin FS. Wrist position and extensor tendon amplitude following repair. J Hand Surg 1992;17A:268-71.
22 Duran RJ, Houser RG, Stover MG. Management of flexor tendon lacerations in zone II using controlled passive motion postoperatively. In: Hunter HM, Schneider LH, Mackin EJ, Bill JA editors. Rehabilitation of the hand. St Louis: Mosby; 1978.
23 Evans RB, Burkhalter WE. A study of the dynamic anatomy of extensor tendons and implications for treatment. J Hand Surg 1986;11A:774-9.
24 Thomas D, Moutet F, Guinard D. Postoperative management of extensor tendon repairs in zones V, VI, and VII. J Hand Ther 1996;9:309-14.