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Published on: March 1, 2024
[Early active motion after transfer of the extensor indicis tendon--a randomised prospective trial]
K Megerle1, M Przybilski, M Sauerbier
1BG-Unfallklinik Ludwigshafen, Klinik für Hand-, Plastische und Rekonstruktive Chirurgie--Schwerbrandverletztenzentrum, Klinik für Plastische und Handchirurgie an der Universität Heidelberg, Ludwigshafen. megerle@bgu-ludwigshafen.de
Background:
We conducted a prospective randomised trial to compare the postoperative results and complications following two postoperative treatment protocols (dynamic motion vs. early active motion) after transfer of the extensor indicis tendon.
Patients And Methods:
21 patients (10 female, 11 male) were randomly assigned to two treatment protocols after transfer of the extensor indicis tendon. In one group of patients ("dynamic"), the reconstructed tendon was extended passively with a rubber band system, in the other study group ("active"), early active extension of the thumb was initiated. Active range of motion in the interphalangeal (IP) and metacarpophalangeal joints (MP) as well as grip and pinch strength were evaluated after the third, fourth, sixth and eighth postoperative week. All complications during the first postoperative year were noted. Statistical analysis was performed with chi-square and Mann-Whitney U-tests.
Results:
After the eighth postoperative week, in the IP joint an average range of motion of 69 degrees (45-110 degrees) was found in the dynamic study group and 58 degrees (40-75 degrees ) in the active study group. After three weeks, patients treated with the dynamic treatment protocol demonstrated significantly (p=0.03) greater ranges of motion, during the further treatment course no significant differences between the two groups were detected. After eight weeks, the average grip and pinch strength was 66 %/73 % of the contralateral side in the dynamic study group and 63 %/71 % in the active study group.
Conclusion:
With respect to the small groups of patients, both treatment protocols demonstrate comparable clinical results after 8 weeks. Early active motion does not result in a higher rate of complications but fails to speed up rehabilitation.
