[Rehabilitation of extensor tendon injuries]

[Treatment of extensor tendon injuries of the hand]

The extensor apparatus of the hand is a complex system consisting of extrinsic and intrinsic muscles, which in combination enable the individual extension of the fingers. Extensor tendon injuries of the hand are frequent injuries and the operative or conservative treatment options are determined by the localization and involvement of osseus structures. For an optimal outcome of the treatment of extensor tendon injuries, correct diagnostics and a consistent hand aftercare are absolutely essential. The crucial decision making regarding the further procedure starts with the initial patient treatment, ideally on the day of trauma.

Comparing three postoperative treatment protocols for extensor tendon repair in zones V and VI of the hand

OBJECTIVE

This pilot study compared the effectiveness of 3 postoperative rehabilitation protocols for patients with Zones V and VI extensor tendon lacerations.

METHOD

Twenty-seven patients were recruited from 3 sites and randomly assigned to 1 of 3 established treatment protocols: immobilization, early passive motion (EPM), and early active motion (EAM). Outcome measures were collected at 3, 6, and 12 wk after treatment and included total active motion (TAM).

RESULTS

At the end of Week 12, data on 24 injured digits of 18 patients were available for analysis. When data at Weeks 3, 6, and 12 were compared, patients in all groups showed steady improvement in TAM, but digits under the EAM treatment improved to a greater extent over time (F[2, 46] = 75.6, p < .001).

CONCLUSION

Patients with Zones V and VI extensor tendon injuries treated with the EAM protocol recovered range of motion more rapidly.