Comparison of two methods of controlled mobilisation of repaired flexor tendons in zone 2

Abstract

The results after primary repair of zone 2 flexor tendon injuries were evaluated in 263 fingers in 192 patients using two different early-controlled mobilisation programmes. There were 126 men and 66 women (age range 18 to 57 years) divided into two groups. Ninety-eight patients with 137 fingers were treated by early active mobilisation with dynamic splinting method according to a modified Kleinert regimen (Washington regimen), and 94 patients with 126 fingers were managed with a controlled passive movement regimen postoperatively. During this evaluation patients were evaluated for total active movement (TAM), grip strength, and disabilities of arm, shoulder, and hand (DASH) questionnaire. All patients were also reviewed 12 weeks after operation and the results assessed by the Buck-Gramcko-II system. Total active movement was excellent in the Washington regimen group (n=119, 87%), while excellent results of the fingers were achieved in the controlled passive movement group (n=94, 75%). The mean grip strength of the injured hand was 89% that of the non-injured side in the Washington regimen group, compared with 81% in the controlled passive movement group. The mean DASH score was 30 and 42 in the two groups, respectively. We think that controlled active mobilisation with dynamic splinting improves the outcome in the upper extremity, including range of movement, grip strength, and functional state of the hand in repairs of the flexor tendons.