Early mobilization of the extensor tendon repair by self made splint

Abstract EN

Background : Acute post traumatic tendon repair immobilized by static splint for several weeks may ended with adhesions and long term rehabilitation.

So early mobilization by simple dynamic splint aids to alleviate these problems, but may otherwise lead to tendon lag as the flexor tendons are more powerful than the extensor tendons, and stiff MPJs as their lateral collateral ligaments shortened if they left for long period extended.

We tried to use a simple (easy made) dynamic splint in a way of right angled splint at the MPJ, full extension of IPJ and slight extension of the wrist joint, to facilitate early movements within the casts.

Traditionally the repaired extensor tendons have been treated postoperatively in static splints for several weeks, leading to formation of adhesions and prolonged rehabilitation.

Early mobilization using dynamic splints is common, but associated with many shortcomings.

We attempted to study the results of early active mobilization, using a simple static splint, and easy-to-follow rehabilitation plan. Materials and Methods : From January 2009 to September 2011 ; 21 cases of extensor tendons in zone 5to 7 were treated with primary or delayed primary repaired (i.e.

2 to 10 days), splinting and early mobilization were undertaken using self-made prefabricated splints.

Our results were evaluated according to the degrees of stiffness of the MPJ and the scope of extension of the extensor tendons in their full range while the hands in a table top flat position. Results : All the 21 patients were followed up for three months.

16 out of 21 patients were 18-35 years of age (76.1 %) all were manual workers, and the rest were bellow 18 (23.9 %), most of them were injured in zone 3(17 out of 21) and 4 cases in zone 4. Conclusion : Early movements of a repaired extensor tendons coincidentally with use of easy self-made splint gives better results from preventing adhesion and MPJ stiffness with a good range of extensor tendon movements.