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Immediate controlled active motion following zone 4-7 extensor tendon repair.
Julianne W Howell1, Wyndell H Merritt, Sandra J Robinson
1Samaritan Hand Therapy Specialists, Albany, Oregon 97321, USA. julianneh@earthlink.net
Summary
This study introduces an immediate controlled active motion (ICAM) splinting program for extensor tendon repairs. The ICAM splinting technique safely improves hand function and patient outcomes with high compliance.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Rehabilitation medicine
Background:
- Extensor tendon injuries in zones 4-7 require careful management to balance repair integrity with functional recovery.
- Traditional immobilization can lead to stiffness and reduced range of motion.
Purpose of the Study:
- To describe and evaluate a novel splinting program for zone 4-7 extensor tendon repairs.
- To assess the safety, efficacy, and patient compliance of immediate controlled active motion (ICAM) splinting.
Main Methods:
- A yoke splint controlling metacarpophalangeal joints and a wrist splint were used to facilitate ICAM.
- The splint positions the injured digit in slight hyperextension relative to others.
- The technique was validated through cadaveric, intraoperative, and 140-patient case studies over 20 years.
Main Results:
- The majority of patients achieved excellent digital extension and flexion.
- Minimal extension lags and no tendon ruptures were observed.
- Patients returned to work in 18 days and completed the program in 7 weeks with 8 therapy visits on average.
Conclusions:
- The ICAM splinting technique is a safe, simple, and cost-effective method for managing zone 4-7 extensor tendon repairs.
- It decreases immobilization morbidity and demonstrates high patient compliance compared to other early motion programs.