M Sanmartín-Fernández1, B Fernández-Bran2, J Couceiro-Otero2. 1. Departamento de Cirugía Ortopédica y Traumatología, Hospital Povisa de Vigo, Vigo, España. Electronic address: m2sanmartin@gmail.com. 2. Departamento de Cirugía Ortopédica y Traumatología, Hospital Povisa de Vigo, Vigo, España.
Abstract
OBJECTIVE: To evaluate the results and complications of flexor tendon repair in which a home-based rehabilitation program was utilized without the assistance of a hand therapist during the first 4postoperative weeks. MATERIAL Y METHODS: Between July 2009 and July 2014, a total of 21 digits in 15 patients were treated in our institution for complete laceration of the flexor tendons within the flexor pulley system (zone 1 and 2). Passive and active exercises performed by the patients themselves were started the morning after the operation. Data, as range-of-motion and complications, were collected 6months after the surgery. RESULTS: Fifteen digits had full recovery of flexion. One patient suffered a rupture in the fifth postoperative week. Ten of the 21 digits developed a flexion contracture of the proximal interphalangeal joint; in 5 the contracture was less or equal to 10° without impairment of function or aesthetics. DISCUSSION: Over recent decades, specialized hand therapy has been of great importance in the postoperative treatment of hand diseases. Unfortunately, these professionals are not always available in our area in the first days after surgery. With this protocol, the patient is in charge of carrying out the postoperative exercises, which could lead to a worse final result and a higher rate of complications. CONCLUSION: The home-based rehabilitation program yielded complete recovery of joint mobility in most cases with a low complication rate.
OBJECTIVE: To evaluate the results and complications of flexor tendon repair in which a home-based rehabilitation program was utilized without the assistance of a hand therapist during the first 4postoperative weeks. MATERIAL Y METHODS: Between July 2009 and July 2014, a total of 21 digits in 15 patients were treated in our institution for complete laceration of the flexor tendons within the flexor pulley system (zone 1 and 2). Passive and active exercises performed by the patients themselves were started the morning after the operation. Data, as range-of-motion and complications, were collected 6months after the surgery. RESULTS: Fifteen digits had full recovery of flexion. One patient suffered a rupture in the fifth postoperative week. Ten of the 21 digits developed a flexion contracture of the proximal interphalangeal joint; in 5 the contracture was less or equal to 10° without impairment of function or aesthetics. DISCUSSION: Over recent decades, specialized hand therapy has been of great importance in the postoperative treatment of hand diseases. Unfortunately, these professionals are not always available in our area in the first days after surgery. With this protocol, the patient is in charge of carrying out the postoperative exercises, which could lead to a worse final result and a higher rate of complications. CONCLUSION: The home-based rehabilitation program yielded complete recovery of joint mobility in most cases with a low complication rate.
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