gms | German Medical Science

Clinical issue/s: Despite numerous studies, achieving the best outcome is challenging after flexor tendon repairs in zone 2. This study was done to test the hypothesis that immediate postoperative active mobilization will achieve similar outcomes to passive mobilization.

Clinical reasoning: Despite numerous advances in our understanding of the anatomy, biomechanics, nutrition and healing of flexor tendons, repair techniques and post-operative care improvement, the results following flexor tendon repairs show relatively high rates of failure. Immediate postoperative active mobilization will achieve better outcomes in comparison to passive mobilization.

Innovative, analytical or new approach: Fifty fingers in 38 patients with flexor tendon repair in zone 2 were enrolled in this trial. The patients were randomly assigned to two groups: Early active mobilization and Passive mobilization. They were assessed eight weeks post-operatively. Outcomes were defined using 'Strickland' and 'Buck-Gramcko' criteria. The analysis was done according to intention-to-treat principles, using imputation for missing data.

Contribution to advancing HT practice: The actively mobilized tendon underwent intrinsic healing without large gap formation. Increased ultimate range of motion confirmed that early active mobilization can be used after strong repair in zone two.