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Comparison of immobilization and early passive motion in the treatment of complex extensor tendon injuries

Year 2001, Volume: 35 Issue: 1, 28 - 34, 11.09.2006

Abstract

Objectives: This study was designed to evaluate the functional results in patients who underwent surgery for complex extensor tendon lacerations in zones V to VII and treated either by immobilization or early passive motion (EPM).
Methods: Eleven patients (31 fingers) were treated by immobilization and nine patients (18 fingers) were treated by the EPM protocol. In the immobilization group, static palmar splints (wrist extension 30-40°; metacarpophalangeal and interphalangeal joints 0°) were used for four weeks. In the EPM group, dynamic splints and an outtrigger splint were applied to hold the wrist 30-40° extended and the metacarpophalangeal and interphalangeal joints in neutral and rubber band-assisted extension and active flexion was started three to five days postoperatively. After a mean follow-up of 22 months, total active motion and extensor lag of each involved finger, grip strength, and duration for return to pre-injury activity were evaluated.
Results: No tendon ruptures occurred. Total active motion of the involved fingers (215°±39.6° vs 241°±36.6°) and duration for return to pre-injury activity (17.8 weeks vs 14.7 weeks) differed significantly in favor of the EPM group (p<0.05). However, no significant difference was observed in grip strength (p>0.05). According to the Miller classification, good and/or excellent results accounted for 32.2% and 61% in the immobilization and EPM groups, respectively.
Conclusion: The study showed that EPM was more effective than the immobilization method in the treatment of complex extensor tendon injuries in zones V to VII.

Ekstensör tendonların kompleks yaralanmalarının tedavisinde immobilizasyon ve erken pasif hareket yöntemlerinin karşılaştırılması

Year 2001, Volume: 35 Issue: 1, 28 - 34, 11.09.2006

Abstract

Amaç: El dorsalinin V, VI ve VII. bölgelerinde ekstensör tendonların kompleks yaralanması nedeniyle ameliyat edilen ve farklı rehabilitasyon programı uygulanan iki hasta grubunda alınan fonksiyonel sonuçlar değerlendirildi.
Çalışma planı: Bu çalışmada, immobilizasyon (11 hasta, 31 parmak) ve erken pasif hareket (EPH) (9 hasta, 18 parmak) yöntemleri ile tedavi edilen 20 hastanın 49 parmağı incelendi. İmmobilizasyon grubunda, el bileğini 30-40° ekstansiyonda, metakarpofalangeal (MP) ve interfalangeal eklemleri nötralde tutan atel dört hafta süreyle kullanıldı. Erken pasif hareket grubunda ise, el bileği 30-40° ekstansiyonda, MP eklemler nötralde olacak şekilde palmardan yapılan dinamik atel yanı sıra parmaklara lastik ve misina aracılığıyla postoperatif 3-5. günlerde aktif fleksiyon ve pasif ekstansiyona başlandı. Ortalama 22 aylık takip dönemi sonunda hastaların toplam aktif hareketleri, ekstansiyon kayıpları, kavrama güçleri ve önceki işlerine geri dönüş süreleri değerlendirildi.
Sonuçlar: Her iki grupta da tendon rüptürü görülmedi. İmmobilizasyon grubu ile EPH grubu arasında toplam aktif hareket değerleri (215°±39.6° ve 241°±36.6°) ve işe dönüş süreleri (17.8 hafta ve 14.7 hafta) yönünden fark istatistiksel olarak anlamlı (p<0.05) bulunurken, kavrama güçleri için fark anlamlı değildi (p>0.05). Miller sınıflamasına göre, immobilizasyon grubunda parmakların %32.2’sinde, EPH grubunda %61’inde iyi veya mükemmel sonuç elde edildi.
Çıkarımlar: Bu çalışma, kompleks ekstensor tendon yaralanmalarının tedavisinde, EPH protokolünün immobilizasyon yöntemine göre daha etkili olduğunu gösterdi.

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Details

Primary Language English
Journal Section Original Article
Authors

Yalcin Ademoglu This is me

Gulin Arikan This is me

Ibrahim Kaplan This is me

Sait Ada This is me

Firdevs Kul This is me

Aysel Enhos This is me

Publication Date September 11, 2006
Published in Issue Year 2001 Volume: 35 Issue: 1

Cite

APA Ademoglu, Y., Arikan, G., Kaplan, I., Ada, S., et al. (2006). Comparison of immobilization and early passive motion in the treatment of complex extensor tendon injuries. Acta Orthopaedica Et Traumatologica Turcica, 35(1), 28-34. https://doi.org/10.3944/aott.v35i1.1831
AMA Ademoglu Y, Arikan G, Kaplan I, Ada S, Kul F, Enhos A. Comparison of immobilization and early passive motion in the treatment of complex extensor tendon injuries. Acta Orthopaedica et Traumatologica Turcica. September 2006;35(1):28-34. doi:10.3944/aott.v35i1.1831
Chicago Ademoglu, Yalcin, Gulin Arikan, Ibrahim Kaplan, Sait Ada, Firdevs Kul, and Aysel Enhos. “Comparison of Immobilization and Early Passive Motion in the Treatment of Complex Extensor Tendon Injuries”. Acta Orthopaedica Et Traumatologica Turcica 35, no. 1 (September 2006): 28-34. https://doi.org/10.3944/aott.v35i1.1831.
EndNote Ademoglu Y, Arikan G, Kaplan I, Ada S, Kul F, Enhos A (September 1, 2006) Comparison of immobilization and early passive motion in the treatment of complex extensor tendon injuries. Acta Orthopaedica et Traumatologica Turcica 35 1 28–34.
IEEE Y. Ademoglu, G. Arikan, I. Kaplan, S. Ada, F. Kul, and A. Enhos, “Comparison of immobilization and early passive motion in the treatment of complex extensor tendon injuries”, Acta Orthopaedica et Traumatologica Turcica, vol. 35, no. 1, pp. 28–34, 2006, doi: 10.3944/aott.v35i1.1831.
ISNAD Ademoglu, Yalcin et al. “Comparison of Immobilization and Early Passive Motion in the Treatment of Complex Extensor Tendon Injuries”. Acta Orthopaedica et Traumatologica Turcica 35/1 (September 2006), 28-34. https://doi.org/10.3944/aott.v35i1.1831.
JAMA Ademoglu Y, Arikan G, Kaplan I, Ada S, Kul F, Enhos A. Comparison of immobilization and early passive motion in the treatment of complex extensor tendon injuries. Acta Orthopaedica et Traumatologica Turcica. 2006;35:28–34.
MLA Ademoglu, Yalcin et al. “Comparison of Immobilization and Early Passive Motion in the Treatment of Complex Extensor Tendon Injuries”. Acta Orthopaedica Et Traumatologica Turcica, vol. 35, no. 1, 2006, pp. 28-34, doi:10.3944/aott.v35i1.1831.
Vancouver Ademoglu Y, Arikan G, Kaplan I, Ada S, Kul F, Enhos A. Comparison of immobilization and early passive motion in the treatment of complex extensor tendon injuries. Acta Orthopaedica et Traumatologica Turcica. 2006;35(1):28-34.