Immediate active short arc motion following extensor tendon repair

Postoperative management of the extensor tendon injury has been altered over the past 15 years from treatment with 4 to 6 weeks of immobilization to controlled passive motion and, now, to active SAM with minimal tension and wrist tenodesis programs. The concepts of immediate motion are supported biochemically in experimental studies, and biomechanically through excursion studies, mathematical analysis of tendon excursion and force application, and study of repair tensile strengths. The results cited in this article and those reported by others demonstrate that early motion for extensor tendons in zones III, IV, V, VI, VII, T IV, and T V is safe and effective if force application is precise. Early referral to therapy, meticulous care in the control of edema, precise positions of postoperative splinting, and controlled motion programs will greatly improve the results of both simple and complex extensor tendon injuries, both in terms of function achieved and in terms of time and expense.