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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Clinical trial of comparing the effects of active and passive rehabilitation on flexor tendons repair outcomes in Zone 2

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  • presenting/speaker Mohammad Javad Fatemi - burn research center, Iran university of medical sciences, Tehran, Iran
  • Tooran Bagheri - Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
  • Roohollah Sobhani - Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
  • Leila Mirzaei - Burn Research Center, Iran University of Medical Sciences, Tehran, Iran

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-310

doi: 10.3205/19ifssh0917, urn:nbn:de:0183-19ifssh09176

Published: February 6, 2020

© 2020 Fatemi et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: The present study aimed to compare early passive and active mobilization on restoration of zone II flexor tendon injuries.

Methods: This was a prospective randomized, controlled trial including 21 patients, 28 fingers with zone II tendon injuries scheduled for tendon repair and rehabilitation who were randomly assigned to receive treatment either with passive motion (PM group) or with early active motion (AM group) rehabilitation. Patients between 15 to 60 years of age, with sharp rapture of zone II flexor tendon, time of injury before 72 hours, residence in Tehran and suburbs, and informed consent forms were included in the study. Total active range of motion (TAM), power of hand griping and pinching were all measured at six, eight, and twelve weeks of follow-up by a blinded independent hand therapist. Early and delayed complications were also recorded by a blinded evaluator. Patients in the both study groups underwent 24 sessions of rehabilitation therapy.

Results and Conclusions: No significant differences were observed between the two groups regarding the demographic characteristics (P > 0.05). None of the patients in the both groups have had tendon rapture, hematoma and infection. Two patients in AM group had flap necrosis which was not significantly different compared to the PM group (P= 0.476). At the first and second follow-up, 95% of patients in both groups (91% and 100% in AM and PM groups, respectively) had edema which was limited to the fingers area and one patient had edema in the hand. The results of wound healing rates were as follow; in the AM group, nine patients excellent and three patients good; in the PM group, eight patients excellent, one patient good and another one fair. The adhesion formation was reported in 8 cases of PM group which was significantly higher than the AM group (one case) (P = 0.003). Extension lag and flexion contracture were not significantly different between the studied groups. Six weeks after surgery, the mean TAM in the Am group was 189.15 ± 51.84 degrees and in the PM group was 144.87 ± 47.32 degrees which was significantly different (P = 0.026). The means of TAM eight and twelve weeks after surgery were not significantly different between the two studied groups (P = 0.207 vs. P = 0.949, respectively).