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Published on: December 10, 2021
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Relative motion flexion following zone I-III flexor tendon repair: Concepts, evidence and practice
Lisa Newington1, Emma Bamford2, Steven L Henry3
1Hand Therapy, Guy's and St Thomas' NHS Foundation Trust, London, UK; MSk Lab, Department of Surgery and Cancer, Imperial College London, Sir Michael Uren Hub, London, UK.
Summary
Relative motion flexion orthoses may aid flexor tendon repair recovery. This approach, utilizing specific finger positioning, aims to reduce tension on the repaired flexor digitorum profundus and protect the flexor digitorum superficialis.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Rehabilitation medicine
Background:
- Flexor tendon repair in zones I-III presents challenges for early active mobilization.
- The relative motion approach hypothesizes reduced tension on repaired tendons via specific joint positioning.
- Potential protective effects on surrounding structures like the flexor digitorum superficialis are also proposed.
Approach:
- A narrative review of existing literature on relative motion flexion orthoses for flexor tendon repair.
- Case series analysis of 18 patients undergoing rehabilitation for zone I-II flexor tendon repair using this method.
- Collection of clinical and patient-reported outcome data to evaluate effectiveness.
Key Points:
- Published outcomes of relative motion flexion orthoses in early active motion for zone I-III flexor digitorum repairs were reviewed.
- Novel outcome data from 18 patients treated with this rehabilitation strategy are presented.
- Discussion includes orthosis fabrication, exercise protocols, and functional hand use considerations.
Conclusions:
- Limited evidence currently supports the use of relative motion flexion orthoses post-flexor tendon repair.
- Highlights the need for further research, including a current pragmatic randomized controlled trial.
- The study discusses practical aspects of implementing this rehabilitation strategy.
