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Early protected motion after extensor tendon repair.

C A Crosby1, M A Wehbé

  • 1Pennsylvania Hand Center, Bryn Mawr 19010, USA.

The Journal of Hand Surgery
|October 6, 1999
PubMed
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Early motion with dynamic splinting and tendon mobilization significantly improves outcomes for extensor tendon repairs. This combined approach enhances range of motion and strength, leading to faster return to activity after hand injuries.

Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Rehabilitation Medicine

Background:

  • Extensor tendon injuries in the hand require effective treatment to restore function.
  • Traditional treatments may have limitations in achieving optimal range of motion and strength.
  • Immediate post-operative mobilization is a key consideration in tendon repair protocols.

Purpose of the Study:

  • To evaluate the efficacy of immediate motion combined with dynamic splinting and a tendon mobilization program for extensor tendon lacerations.
  • To compare the outcomes of this comprehensive rehabilitation approach with previously published data.
  • To assess the recovery of range of motion, strength, and return to activity following surgical repair.

Main Methods:

  • Surgical repair of 50 extensor tendon lacerations in 30 hands (excluding mallet finger injuries).

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  • Implementation of a post-operative rehabilitation program featuring dynamic splinting and immediate tendon mobilization.
  • Average follow-up of 7 months, with assessment of range of motion, strength, and functional recovery.

    • Main Results:

    • 45 out of 50 repaired tendons regained full range of motion (average 262 degrees) within 9 weeks.
    • The remaining 5 tendons showed minimal extension lags (≤10 degrees).
    • Patients achieved at least 93% of predicted normal strength within 9-12 weeks and returned to prior activity levels in an average of 10 weeks.

    Conclusions:

    • The combination of dynamic splinting and a tendon mobilization program represents an advancement in the treatment of extensor tendon repairs.
    • This integrated approach leads to superior functional recovery, including improved range of motion and strength.
    • The findings suggest that early, active rehabilitation is crucial for optimizing outcomes in hand extensor tendon injuries.