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Egyptian Rheumatology and Rehabilitation
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Comparative study between early active and passive rehabilitation protocols following two-strand flexor tendon repair: can two-strand flexor tendon repair withstands early active rehabilitation?

Egyptian Rheumatology and Rehabilitation volume 45, pages 125–132 (2018)Cite this article

Abstract

Background

Restoration of full range of motion of digits as well as prevention of joint contracture following flexor tendon repair is a challenge. There is lack of solid evidence regarding the most suitable rehabilitation protocol following flexor tendon repair. This is owing to the limited number of studies comparing different rehabilitation protocols. Moreover, the present studies advocate a specific technique with no comparative group. Even the few controlled studies conducted vary in methods of repair and rehabilitation, and outcome assessment. To our knowledge, the only randomized controlled trial comparing early passive rehabilitation with early active rehabilitation is the one done by Trumble and colleagues in 2010, which was done on four-strand repaired tendon. These authors concluded that active rehabilitation program had better range of motion with less flexion contractures and greater satisfaction scores than those subjected to passive rehabilitation protocol.

Aim

This conclusion stimulated us to study the effect of early active mobilization versus early passive mobilization following two-strand repair.

Patient and methods

We conducted our study for 12 weeks comparing early active mobilization protocol ‘place and hold’ with early passive mobilization ‘modified Kleinert’ after standard two-strand modified Kessler repair in different hand zones.

Results and conclusion

We concluded that early active mobilization had better tendon gliding and excursion even with the two-strand repair as active motion will decrease adhesion formation, with significant difference compared with the passive group. Moreover, there was no significant difference in the rupture rate and significant difference for combined tendon lag and flexion deformity owing to the tenodesis mobilization between both the groups.

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Authors and Affiliations

  1. Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Ain Shams University, 56 Ramsis Street, Abbasseya, Cairo, 11566, Egypt

    Hala M. Abdel Sabour MD

  2. Departments of Plastic Surgery, Ain Shams University, Cairo, Egypt

    Amir Labib & Ahmed Abel Sallam

  3. Departments of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Mohey Elbanna

Authors
  1. Hala M. Abdel Sabour MD
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  2. Amir Labib
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  3. Ahmed Abel Sallam
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  4. Mohey Elbanna
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Corresponding author

Correspondence to Hala M. Abdel Sabour MD.

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Abdel Sabour, H.M., Labib, A., Sallam, A.A. et al. Comparative study between early active and passive rehabilitation protocols following two-strand flexor tendon repair: can two-strand flexor tendon repair withstands early active rehabilitation?. Egypt Rheumatol Rehabil 45, 125–132 (2018). https://doi.org/10.4103/err.err_15_18

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