gms | German Medical Science

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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A prospective randomized controlled trial of controlled passive mobilization vs. place and active hold exercises after zone 2 flexor tendon repair

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  • presenting/speaker Maryam Farzad - Uswr, Tehran, Iran
  • Erfan Shafiee - Uswr, Tehran, Iran
  • Fereydoun Layeghi - Uswr, 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. DocIFSHT19-1012

doi: 10.3205/19ifssh1453, urn:nbn:de:0183-19ifssh14530

Published: February 6, 2020

© 2020 Farzad 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

Text

Clinical issue/s: The rehabilitation program after flexor tendon repair of zone II laceration varies.

We designed a Prospective Randomized Controlled Trial of controlled passive mobilization (modified Kleinert) vs. Place and active hold exercises after zone 2-flexor tendon repair by two-strand suture (Modified kessler).

Clinical reasoning: Based on the rationale that active motion creates much greater excursion of the flexor tendon within the sheath than passive motion, and holding the repaired tendon actively can have similar advantages as active flexing the repaired tendon with less tension.

We performed a prospective randomized controlled trial to compare controlled passive mobilization (CPM) and place and active hold exercises (PAH) in patients with zone 2 flexor tendon lacerations repaired with a two-stran repair.

We tested the null hypothesis that there is no difference in the average total active motion (TAM) between PAH and CPM cohorts eight weeks after repair.

Innovative, analytical or new approach: Sixty-four fingers in 54 patients with zone 2 flexor tendon modified Kessler repairs were enrolled in a prospective randomized controlled trial comparing place and active hold exercises to controlled passive mobilization (modified Kleinert).

The primary outcome measure was total active motion eight weeks after repair as measured by an independent and blinded therapist.

Contribution to advancing HT practice: The place and active hold protocol has achieved motion similar to most studies reporting fully active motion.

PAH is relatively easy to learn and can be used with conventional suture techniques.