Dynamic extension assist splinting of acute central slip lacerations

The management of zone III extensor tendon injuries remains a challenging clinical problem for both the surgeon and therapist. Current treatment protocols include prolonged immobilization, controlled mobilization, or limited early dynamic splinting, but overall results are often less than optimal. This retrospective study describes an alternative treatment approach for acute central slip lacerations consisting of initial immobilization of the PIP joint in absolute 0 degrees extension for an average of 3.5 weeks followed by active flexion of the PIP joint in a finger-based dynamic extension assist splint. Therapy averaged approximately one visit weekly, and follow-up averaged 3.8 months. Mean PIP joint extension was + 1 degrees, and mean PIP joint flexion was 109 degrees. Mean DIP joint extension was -1 degree and mean DIP flexion was 67 degrees. Mean total active motion measured in composite fashion for the PIP and DIP joints was 175 degrees. This treatment approach produced excellent results, required infrequent therapy, and utilized only finger-based splinting.