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Active motion therapy yields more active finger motion after zone-II flexor tendon repair
Trumble TE. J Bone Joint Surg Am. 2010;92(6):1381-1389. doi:10.2106/JBJS.H.00927.
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For the first time, a prospective, randomized trial has compared the results of patients treated with an active therapy program and those treated with a passive motion program after zone-II flexor tendon repair.
From January 1996 to December 2001, researchers randomized 103 patients (119 digits) with zone-II flexor tendon repairs to either early active motion with place and hold or a passive motion program. Led by Thomas E. Trumble, MD, University of Washington Medical Center, the researchers measured range of motion at 6, 12, 26 and 52 weeks after the repair. At 52 weeks, 93 patients (106 digits) completed dexterity tests, the Disabilities of the Arm, Shoulder and Hand (DASH) outcome satisfaction questionnaire and a satisfaction score.
At each follow-up point, patients in the active motion program had more interphalangeal joint motion. At final follow-up, the interphalangeal joint motion in the active place and hold group was a mean 156° ± 25° compared with 128° ± 22° in the passive motion group (P<.05). The active motion group had significantly smaller flexion contractures and better satisfaction scores (P<.05), the authors wrote.
Both groups had similar DASH scores and dexterity tests, Trumble and colleagues found. Stratification revealed that smokers and patients with a concomitant nerve injury or multiple digit injuries had less range of motion, larger flexion contractures and lower satisfaction scores.
Patients who were treated by a certified hand therapist had better range of motion with smaller flexion contractures.
“Active motion therapy provides greater active finger motion than passive motion therapy after zone-II flexor tendon repair without increasing the risk of tendon rupture,” the researchers wrote.