A randomized clinical trial comparing immediate active motion with immobilization after tendon transfer for claw...

Area of Science:

• Orthopedics
• Hand Surgery
• Rehabilitation Medicine

Background:

• Conventional postoperative management for tendon transfers involves immobilization.
• Previous studies suggested benefits of an immediate active motion protocol (IAMP) for claw deformity correction.

Purpose of the Study:

• To compare the effectiveness of IAMP versus conventional immobilization in a randomized clinical trial.
• To evaluate IAMP's impact on deformity correction, range of motion, and patient recovery after tendon transfer.

Main Methods:

• A randomized clinical trial involving 50 patients with supple claw hand deformities.
• Two groups: immediate active motion protocol (IAMP) starting on postoperative day 2, and immobilization starting on postoperative day 22.
• Primary outcomes included deformity correction, active range of motion, tendon pullout, and time to discharge; secondary outcomes included pain, swelling, strength, and dexterity.

Main Results:

• No significant differences in deformity correction, range of motion, swelling, dexterity, or hand strength between groups.
• No tendon insertion pullout observed in either group.
• IAMP group experienced significantly earlier pain relief and a 22-day reduction in morbidity.

Conclusions:

• Immediate active motion protocol (IAMP) is a safe alternative to immobilization after tendon transfer.
• IAMP offers advantages of earlier pain relief and accelerated hand function restoration.
• Early motion can reduce rehabilitation time and costs for patients with paralytic limbs.