Immobilization versus Early Active Mobilization after Zone 5-6 extensor tendon repair

Area of Science:

• Orthopedic surgery
• Hand surgery
• Rehabilitation medicine

Background:

• Extensor tendon injuries in the dorsal hand are common due to the tendons' superficial location.
• Early active mobilization (EAM) is gaining traction, but comparative data against immobilization is limited.

Purpose of the Study:

• To compare short-term functional outcomes and return-to-work times for EAM versus immobilization after zone 5-6 extensor tendon repairs.

Main Methods:

• Retrospective cohort study of 26 patients with zone 5-6 extensor tendon injuries.
• Assessed range of motion (goniometer) and grip strength (dynamometer).
• Collected data on return-to-work times and physiotherapy sessions; analyzed occupation type and hand dominance.

Main Results:

• EAM group showed significantly better metacarpophalangeal, distal interphalangeal, and total active motion at discharge (p<0.05) with large effect sizes.
• No significant differences in grip strength, return-to-work times, or physiotherapy sessions between groups (p>0.05).
• Occupation and hand dominance did not impact return-to-work outcomes; no tendon ruptures occurred.

Conclusions:

• EAM enhances short-term range of motion after zone 5-6 extensor tendon repair without increasing complications.
• Grip strength and return-to-work outcomes are comparable to immobilization.
• EAM is a safe and effective rehabilitation strategy for these injuries.