Florian Samuel Frueh1, Viviane Sylvie Kunz2, Isaac Joseph Gravestock2, Leonhard Held2, Mathias Haefeli2, Pietro Giovanoli2, Maurizio Calcagni2. 1. Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland; Division of Biostatistics, Institute for Social and Preventive Medicine, University of Zurich, Zurich, Switzerland. Electronic address: florian.frueh@usz.ch. 2. Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland; Division of Biostatistics, Institute for Social and Preventive Medicine, University of Zurich, Zurich, Switzerland.
Abstract
PURPOSE: To compare early passive mobilization (EPM) with controlled active motion (CAM) after flexor tendon surgery in zones 1 and 2. METHODS: We performed a retrospective analysis of collected data of all patients receiving primary flexor tendon repair in zones 1 and 2 from 2006 to 2011, during which time 228 patients were treated, and 191 patients with 231 injured digits were eligible for study. Exclusion criteria were replantation, finger revascularization, age younger than 16 years, rehabilitation by means other than EPM or CAM, and missing information regarding postoperative rehabilitation. This left 132 patients with 159 injured fingers for analysis. The primary endpoint was the comparison of total active motion (TAM) values 4 and 12 weeks after surgery between the EPM and the CAM protocols. The analysis of TAM measurements under the rehabilitation protocols was conducted using t-tests and further linear modeling. We defined rupture rate and the assessment of adhesion/infection as secondary endpoints. RESULTS: There was a statistically significant difference between the TAM values of the EPM and the CAM protocols 4 weeks after surgery. At 12 weeks, however, there was no significant difference between the 2 protocols. Older age and injuries with finger fractures were associated with lower TAM values. Rupture rates were 5% (CAM) and 7% (EPM), which were not statistically different. CONCLUSIONS: This study showed a favorable effect of CAM protocol on TAM 4 weeks after surgery. The percent rupture rate was slightly lower in the patients with CAM than in the patients with EPM regime. Further studies are required to confirm our results and to investigate whether faster recovery of TAM is associated with shorter time out of work. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.
PURPOSE: To compare early passive mobilization (EPM) with controlled active motion (CAM) after flexor tendon surgery in zones 1 and 2. METHODS: We performed a retrospective analysis of collected data of all patients receiving primary flexor tendon repair in zones 1 and 2 from 2006 to 2011, during which time 228 patients were treated, and 191 patients with 231 injured digits were eligible for study. Exclusion criteria were replantation, finger revascularization, age younger than 16 years, rehabilitation by means other than EPM or CAM, and missing information regarding postoperative rehabilitation. This left 132 patients with 159 injured fingers for analysis. The primary endpoint was the comparison of total active motion (TAM) values 4 and 12 weeks after surgery between the EPM and the CAM protocols. The analysis of TAM measurements under the rehabilitation protocols was conducted using t-tests and further linear modeling. We defined rupture rate and the assessment of adhesion/infection as secondary endpoints. RESULTS: There was a statistically significant difference between the TAM values of the EPM and the CAM protocols 4 weeks after surgery. At 12 weeks, however, there was no significant difference between the 2 protocols. Older age and injuries with finger fractures were associated with lower TAM values. Rupture rates were 5% (CAM) and 7% (EPM), which were not statistically different. CONCLUSIONS: This study showed a favorable effect of CAM protocol on TAM 4 weeks after surgery. The percent rupture rate was slightly lower in the patients with CAM than in the patients with EPM regime. Further studies are required to confirm our results and to investigate whether faster recovery of TAM is associated with shorter time out of work. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.
Authors: Joachim Gülke; Martin Mentzel; Gert Krischak; David Gulkin; Daniel Dornacher; Nikolaus Wachter Journal: Unfallchirurg Date: 2018-07 Impact factor: 1.000
Authors: Özgün Barış Güntürk; Murat Kayalar; İbrahim Kaplan; Abuzer Uludağ; Kemal Özaksar; Beray Keleşoğlu Journal: Acta Orthop Traumatol Turc Date: 2018-06-29 Impact factor: 1.511
Authors: Weifeng Zeng; Nicholas J Albano; Ruston J Sanchez; Ronald Mccabe; Ray Vanderby; Samuel O Poore; Aaron M Dingle Journal: Plast Reconstr Surg Glob Open Date: 2020-12-17