Reduced Pain and Edema Following Delayed Therapy for Flexor Tenolysis

Area of Science:

• Orthopedic Surgery
• Physical Therapy
• Rehabilitation Medicine

Background:

• Traditional flexor tenolysis protocols initiate therapy 1 day post-surgery to prevent adhesions.
• Postoperative pain and edema can impede early home therapy program initiation and effectiveness.

Purpose of the Study:

• To evaluate the safety and efficacy of delaying physical therapy initiation to 3 days post-operation following flexor tenolysis.
• To assess the impact of delayed therapy on pain, edema, range of motion, and functional limitations.

Main Methods:

• A case series of 10 patients undergoing flexor tenolysis with therapy initiated at 3 days post-op.
• Measurements included pain, edema, range of motion, functional limitations, and anxiety levels at various postoperative time points.

Main Results:

• Significant improvements in interphalangeal joint total active motion were observed by 3 weeks post-op (142.5° ± 24.6°), maintained through 8 weeks.
• Five patients achieved excellent results, three good, and two fair, based on the Strickland Classification at 8 weeks.
• Patients with less initial postoperative edema showed better range of motion at 3 weeks.

Conclusions:

• Delaying physical therapy initiation to 3 days post-flexor tenolysis is safe and yields favorable outcomes.
• Reduced pain and edema facilitate improved range of motion and potentially fewer therapy visits.
• This modified approach can mitigate adverse surgical effects and enhance overall patient recovery.