gms | German Medical Science

Objectives/Interrogation: Recent literature suggests dynamic follow-up treatment after extensor-tendon repair. In these patients improved range of motion is reported especially in the first three months after the accident. Additionally, no increased risk of adverse events or secondary tendon rupture is reported. We started using an immediate controlled active motion orthosis (Yoke Orthosis) after extensor-tendon repair in the Zones 5 to 7. The aim of this study is to evaluate the results of this follow-up treatment.

Methods: We reviewed 42 patients who had an extensor tendon repair from 2016 to 2018. A modified Zechner suture und a running epitendinous suture was performed within 6 hours after the accident. The controlled active motion orthosis was applied the first day after surgery for 3 weeks day and night and another 3 weeks during heavy manual activities. Range of motion was measured 3 weeks after the tendon suture in the MCP, PIP and DIP joint.

Results and Conclusions: In total 29 patients were male and in 22 cases the right side was affected. The mean age was 33 ± 14 years, mean follow-up was 38 ± 20 days, mean sick leave was 37 ± 11 days. In 24 cases the middle finger was affected in 5, 7 and 6 cases the index, ring, and small finger, respectively. 37 injuries were in Zone 5 and 5 in Zone 6. After 3 weeks 40 patients (95,2%) showed full range of motion in the MCP, PIP and DIP joint. One patient (2,4%) presented with a 20°, and one patient (2,4%) with a 10° extension deficit in the MCP joint. No flexion deficit was reported. No adverse events were noticed.

In conclusion, a controlled active motion orthosis provides excellent results 3 weeks after the accident. No increased risk of secondary tendon rupture is observed.