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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Rehabilitation following flexor pollicis longus (FPL) tendon repair: A pilot study comparing early active mobilisation (EAM) with immobilisation (IM)

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  • presenting/speaker Elaine Duguid - Manukau Super Clinic, Hand Therapy, Module 5, Manukau City, Auckland, New Zealand
  • Shirley Collocott - Manukau Super Clinic, Hand Therapy, Module 5, Manukau City, Auckland, New Zealand
  • Ashwini Pondicherry - Manukau Super Clinic, Hand & Plastics, Module 5, Manukau City, Auckland, New Zealand
  • Michael Foster - Manukau Super Clinic, Hand & Plastics, Module 5, Manukau City, Auckland, New Zealand

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. DocIFSHT19-1202

doi: 10.3205/19ifssh1511, urn:nbn:de:0183-19ifssh15119

Published: February 6, 2020

© 2020 Duguid 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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Objective: Early mobilisation has shown superior outcomes to immobilisation following flexor tendon repair. However, the rupture rate is higher for FPL compared with finger flexors (Elliott 2012). There are limited published studies specific to FPL. Data are often grouped with finger flexor studies, making useful interpretation of results difficult (Sirotakova & Elliot 1999). Those comparing FPL rehabilitation are mostly retrospective. This pilot prospectively compared the outcomes of EAM with IM following FPL repair.

Materials and Methods: During 2016-2018 consenting participants who underwent a primary FPL repair were recruited. Surgery technique was standardised and participants randomised into EAM or IM group. Reviews were undertaken by a blinded assessor at 3 & 6 months post-op. The primary outcome was range of interphalangeal joint of the injured thumb using Buck-Gramcko score II (BG II). Secondary outcomes were White score, key pinch, grip strength, Quick-DASH, Patient Evaluation Measure (PEM) 2 and 3, modified Sollerman and complications, including rupture rate.

Results: The 3 months post op results are currently available for 27 participants: BG II (% with excellent score): EAM 61.5% (n=8/13), IM 35.7% (n=5/14); White (% with excellent score): EAM 30.7% (n=4/13), IM 21.4% (n=3/14); key pinch (mean kg): EAM 6.4, IM 5.9; grip (mean kg): EAM 31.8, IM 28.2; Quick-DASH (mean): EAM 24.4, IM 28.2; PEM2 (mean %): EAM 70.7, IM 67.4; PEM3 (mean %): EAM 80.3, IM 75.4; modified Sollerman (mean score): EAM 10.2, IM 10. Further surgery for complications: EAM n=0/13, IM n=3/14. No ruptures reported in either group.

Conclusions: Preliminary results show a trend toward more favourable outcomes in the EAM group compared with IM group. Complete results including full statistical analysis will indicate whether these differences are maintained in the total sample and are statistically significant.