Early controlled passive motion regime for zone II extensor tendon injury--a case report

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Rehabilitation Medicine

Background:

• Zone II extensor tendon injuries, often caused by lacerations or saw accidents, typically require 4-6 weeks of immobilization.
• Standard treatment involves static splinting followed by gradual range of motion (ROM) exercises for the distal interphalangeal (DIP) joint.
• A common complication of this treatment is a stiff DIP joint, with attempts to increase flexion often worsening extensor lag.

Observation:

• Zone II extensor tendon injuries present a challenge in achieving optimal finger function post-immobilization.
• The delicate nature of the extensor mechanism in Zone II makes it susceptible to adhesions and stiffness.
• Balancing extensor tendon healing with the need for joint mobility is critical for functional recovery.

Findings:

• A novel dynamic passive mobilization (DPM) program was implemented for Zone II extensor tendon injuries.
• The DPM program demonstrated effectiveness in managing these injuries.
• Crucially, the DPM program successfully prevented the development of DIP joint stiffness.

Implications:

• Dynamic passive mobilization offers a promising alternative to traditional static splinting for Zone II extensor tendon injuries.
• This approach may lead to improved functional outcomes and reduced long-term complications like joint stiffness.
• Further research into DPM protocols could refine hand surgery rehabilitation strategies.