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Rehabilitation Regimens Following Surgical Repair of Extensor Tendon Injuries of the Hand—A Systematic Review of Controlled Trials

  • Original Article
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Journal of Hand and Microsurgery

Abstract

There is no consensus on the most effective rehabilitation regimen following extensor tendon repair of the hand. This systematic review evaluates the outcomes of the various regimens. The Cochrane, MEDLINE, EMBASE, CINAHL, AMED, PEDro, OTseeker databases were searched for any prospective randomised clinical trials comparing rehabilitation regimens for acute extensor tendon injuries in adults. Five papers met the inclusion criteria. The regimens were static immobilisation, dynamic splinting and early active motion (EAM). There was no standard format of reporting. The sample size ranged from 27 to 100 patients. The duration of follow-up ranged from 8 to 24 weeks. Overall, patients’ total active motion improved with time. Early mobilisation regimens (active and passive) achieve quicker recovery of motion than static immobilisation but the long-term outcome appears similar. Given the comparable outcomes between dynamic splinting and EAM, we therefore favour EAM which is simpler and more convenient.

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References

  1. Rockwell WB, Butler PN, Byrne BA (2000) Extensor tendon: anatomy, injury, and reconstruction. Plast Reconstr Surg 106(7):1592–1603, quiz 1604, 1673

    Article  PubMed  CAS  Google Scholar 

  2. Zilber S, Oberlin C (2004) Anatomical variations of the extensor tendons to the fingers over the dorsum of the hand: a study of 50 hands and a review of the literature. Plast Reconstr Surg 113(1):214–221. doi:10.1097/01.PRS.0000091163.86851.9C

    Article  PubMed  Google Scholar 

  3. von Schroeder HP, Botte MJ (1997) Functional anatomy of the extensor tendons of the digits. Hand Clin 13(1):51–62

    Google Scholar 

  4. Evans RB (1986) Therapeutic management of extensor tendon injuries. Hand Clin 2(1):157–169

    PubMed  CAS  Google Scholar 

  5. Eissens MH, Schut SM, van der Sluis CK (2007) Early active wrist mobilization in extensor tendon injuries in zones 5, 6, or 7. J Hand Ther 20(1):89–91. doi:10.1197/j.jht.2006.11.003

    Article  PubMed  CAS  Google Scholar 

  6. Boyer MI (2005) Flexor tendon biology. Hand Clin 21(2):159–166. doi:10.1016/j.hcl.2004.11.009

    Article  PubMed  Google Scholar 

  7. Tang JB (2005) Clinical outcomes associated with flexor tendon repair. Hand Clin 21(2):199–210. doi:10.1016/j.hcl.2004.11.005

    Article  PubMed  Google Scholar 

  8. Vucekovich K, Gallardo G, Fiala K (2005) Rehabilitation after flexor tendon repair, reconstruction, and tenolysis. Hand Clin 21(2):257–265. doi:10.1016/j.hcl.2004.11.006

    Article  PubMed  Google Scholar 

  9. Khandwala AR, Webb J, Harris SB, Foster AJ, Elliot D (2000) A comparison of dynamic extension splinting and controlled active mobilization of complete divisions of extensor tendons in zones 5 and 6. J Hand Surg Br 25(2):140–146. doi:10.1054/jhsb.1999.0356

    Article  PubMed  CAS  Google Scholar 

  10. Chester DL, Beale S, Beveridge L, Nancarrow JD, Titley OG (2002) A prospective, controlled, randomized trial comparing early active extension with passive extension using a dynamic splint in the rehabilitation of repaired extensor tendons. J Hand Surg Br 27(3):283–288. doi:10.1054/jhsb.2001.0745

    Article  PubMed  CAS  Google Scholar 

  11. Russell RC, Jones M, Grobbelaar A (2003) Extensor tendon repair: mobilise or splint? Chir Main 22(1):19–23

    Article  PubMed  CAS  Google Scholar 

  12. Talsma E, de Haart M, Beelen A, Nollet F (2008) The effect of mobilization on repaired extensor tendon injuries of the hand: a systematic review. Arch Phys Med Rehabil 89(12):2366–2372. doi:10.1016/j.apmr.2008.06.019

    Article  PubMed  Google Scholar 

  13. Sameem M, Wood T, Ignacy T, Thoma A, Strumas N (2011) A systematic review of rehabilitation protocols after surgical repair of the extensor tendons in zones V-VIII of the hand. J Hand Ther 24(4):365–373. doi:10.1016/j.jht.2011.06.005

    Article  PubMed  Google Scholar 

  14. Higgins JPT, Green S (2011) Highly sensitive search strategies for identifying reports of randomized controlled trials in MEDLINE. In: Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.Q [updated March 2011]. The Cochrane Library. pp Available from www.cochrane-handbook.org

  15. Handoll HHG, Vaghela MV (2004) Interventions for treating mallet finger injuries. Cochrane Database of Systematic Reviews: Issue 3. Art. No.: CD004574

  16. Bulstrode NW, Burr N, Pratt AL, Grobbelaar AO (2005) Extensor tendon rehabilitation a prospective trial comparing three rehabilitation regimes. J Hand Surg Br 30(2):175–179. doi:10.1016/j.jhsb.2004.10.016

    Article  PubMed  CAS  Google Scholar 

  17. Hall B, Lee H, Page R, Rosenwax L, Lee AH (2010) Comparing three postoperative treatment protocols for extensor tendon repair in zones V and VI of the hand. Am J Occup Ther 64(5):682–688

    Article  PubMed  Google Scholar 

  18. Mowlavi A, Burns M, Brown RE (2005) Dynamic versus static splinting of simple zone V and zone VI extensor tendon repairs: a prospective, randomized, controlled study. Plast Reconstr Surg 115(2):482–487

    Article  PubMed  Google Scholar 

  19. Kleinert HE, Verdan C (1983) Report of the committee on tendon injuries (International Federation of Societies for Surgery of the Hand). J Hand Surg Am 8(5 Pt 2):794–798

    PubMed  CAS  Google Scholar 

  20. Sauerland S, Lefering R, Bayer-Sandow T, Bruser P, Neugebauer EA (2003) Fingers, hands or patients? The concept of independent observations. J Hand Surg Br 28(2):102–105

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Upper Limb Unit, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, Lancashire, WN6 9EP, UK

    Chye Yew Ng, David Nuttall & Adam C. Watts

  2. Therapies Department, St George’s Hospital, London, UK

    Joelle Chalmer

  3. Department of Trauma & Orthopaedics, Royal Alexandra Hospital, Paisley, UK

    Duncan J. M. Macdonald

  4. Department of Trauma & Orthopaedics, Leicester Royal Infirmary, Leicester, UK

    Saurabh S. Mehta

Authors
  1. Chye Yew Ng
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  2. Joelle Chalmer
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  3. Duncan J. M. Macdonald
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  4. Saurabh S. Mehta
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  5. David Nuttall
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  6. Adam C. Watts
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Correspondence to Chye Yew Ng.

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Ng, C.Y., Chalmer, J., Macdonald, D.J.M. et al. Rehabilitation Regimens Following Surgical Repair of Extensor Tendon Injuries of the Hand—A Systematic Review of Controlled Trials. J Hand Microsurg 4, 65–73 (2012). https://doi.org/10.1007/s12593-012-0075-x

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  • DOI: https://doi.org/10.1007/s12593-012-0075-x

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