Flexor Tendon Injuries –Repair and Reconstruction-Zone-II Flexor Tendon Repair: A Randomized Prospective Trial of Active Place-and-Hold Therapy Compared with Passive Motion Therapy

Zone-II Flexor Tendon Repair: A Randomized Prospective Trial of Active Place-and-Hold Therapy Compared with Passive Motion Therapy

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This study compared the results of patients who underwent active therapy or passive motion therapy following zone-II flexor tendon repair. The study included 103 patients with a total of 119 injured digits. Patients were randomized to either early active motion with place and hold therapy or a passive motion protocol. Range of motion was measured at six, twelve, twenty-six, and fifty-two weeks following repair. Dexterity tests were performed and a Disabilities of the Arm, Shoulder, and Hand (DASH) outcome questionnaire and satisfaction score were completed at fifty-two weeks. The results showed that patients treated with active motion therapy had greater interphalangeal joint motion at all time points. At the final follow-up, the active motion group had significantly greater interphalangeal joint motion, smaller flexion contractures, and greater satisfaction scores compared to the passive motion group. There was no difference between the groups in terms of DASH scores or dexterity tests. Patients with concomitant nerve injuries, multiple digit injuries, and a history of smoking had poorer outcomes compared to patients without these comorbidities. Treatment by a certified hand therapist resulted in better range of motion with smaller flexion contractures. Two digits in each group had tendon ruptures following repair. The study concluded that active motion therapy provides greater active finger motion than passive motion therapy after zone-II flexor tendon repair without increasing the risk of tendon rupture.

Keywords

active therapy

passive motion therapy

zone-II flexor tendon repair

patients

randomized

range of motion

DASH scores

dexterity tests

satisfaction scores

hand therapist