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Range of Motion Following Flexor Tendon Repair: Comparing Active Flexion and Extension With Passive Flexion Using
Markus Renberg1, Jonas Svingen1, Marianne Arner2
1Department of Hand Surgery, Plastic Surgery, and Burns, Linköping University, Linköping, Sweden; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
The Journal of Hand Surgery
|October 1, 2024
Summary
Early active motion (EAM) and passive flexion rehabilitation after flexor tendon repair show similar long-term range of motion outcomes. This large registry study suggests EAM does not offer superior results compared to passive protocols.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Rehabilitation medicine
Background:
- Flexor tendon repair in zones 1 and 2 is crucial for hand function.
- Rehabilitation protocols significantly impact functional recovery and range of motion.
- Early active motion (EAM) and passive motion protocols are common post-repair strategies.
Purpose of the Study:
- To compare the range of motion outcomes between early active motion (EAM) and passive flexion (Kleinert regimen) after flexor tendon repair in zones 1 and 2.
- To evaluate the long-term effectiveness of different rehabilitation approaches.
Main Methods:
- A large-scale retrospective study using data from the Swedish national health care registry for hand surgery (HAKIR).
- Comparison of 828 digits at 3 months and 448 digits at 12 months, analyzing outcomes based on caregiver-chosen rehabilitation regimens (EAM vs. passive flexion).
- Thumbs were analyzed separately to account for unique biomechanics.
Main Results:
- No significant difference in total active motion was observed between the EAM and passive flexion groups at the 12-month follow-up.
- The study included a substantial number of digits, providing robust statistical power.
Conclusions:
- The findings support the hypothesis that early active motion rehabilitation may not yield superior long-term range of motion compared to passive motion protocols after flexor tendon repair in zones 1 and 2.
- This registry study suggests that clinicians can consider various rehabilitation strategies, as EAM does not appear to offer a definitive advantage in long-term motion recovery.
