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Early Active Mobilization Vs Immobilization Following Modified Kessler Repair Of Extrinsic Extensor Tendons In Zone V

Muhammad Jibran Rabbani1, Muhammad Amin2, Kamran Khalid2

  • 1Hashmat Effendi Burns and Plastic Surgery Department, Shalamar Medical and Dental College / SIHS, Lahore, Pakistan.

Journal of Ayub Medical College, Abbottabad : JAMC
|September 20, 2019
PubMed
Summary
This summary is machine-generated.

Early active mobilization (EAM) after extensor tendon repair in zones V-VII leads to better outcomes. EAM resulted in improved range of motion and reduced complications compared to immobilization.

Keywords:
Extensor tendon injuryZone V; Zone VIzone VII; Early active mobilization

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Rehabilitation Medicine

Background:

  • Rehabilitation of extensor tendon repairs in zones V-VII remains debated, with options including immobilization or splint-constrained mobilization.
  • While early mobilization shows promise, existing studies have limitations, including retrospective designs and lack of proper controls.
  • This study aimed to compare functional outcomes of early active mobilization versus immobilization for extensor tendon repairs in zones V-VII.

Purpose of the Study:

  • To compare the functional outcomes of early active mobilization (EAM) against immobilization following extensor tendon repair in zones V-VII.
  • To evaluate differences in total active motion (TAM), pain, and complication rates between the two rehabilitation protocols.
  • To provide evidence-based guidance for the optimal rehabilitation strategy after extensor tendon injuries in these specific zones.

Main Methods:

  • A randomized control trial involving 50 patients with extensor tendon injuries in zones V-VII.
  • Patients were randomly assigned to either early active mobilization (Group A) or immobilization (Group B).
  • Extensor tendon repairs were performed using the modified Kessler method; TAM and pain were assessed, with TAM in Group B assessed after four weeks.

Main Results:

  • 12% of patients in the EAM group achieved excellent outcomes, with no fair results.
  • In contrast, the immobilization group had no excellent results, with 4% achieving fair outcomes.
  • Adhesion formation was significantly higher in the immobilization group, though suture dehiscence was similar (8%) in both groups.

Conclusions:

  • Early active mobilization (EAM) demonstrates superior functional outcomes compared to immobilization for extensor tendon repairs in zones V-VII.
  • EAM leads to better range of motion and potentially fewer complications like adhesions.
  • The findings support EAM as a preferred rehabilitation method for these injuries.