Article

Injuries to adjacent fingers with
differing extensor tendon (ET) zones and/or sagittal band pose a challenge to
therapists as no treatment guidelines exist. This report
highlights how the relative motion flexion/extension (RMF/RME) concepts were
combined into one orthosis to manage a zone IV ET repair (RME) and a zone III
central slip repair (RMF) in adjacent fingers (Case 1);
and how a single RME
orthosis was adapted to limit proximal interphalangeal joint motion to manage
multi-level ET zone III-IV injuries and a sagittal band repair in adjacent
fingers (case 2). METHODS: Adapted relative motion orthoses allowed early active
motion and graded exercises based on clinical reasoning and evidence. Outcomes
were standard TAM% and Miller's criteria. RESULTS: 'Excellent' and 'good'
outcomes were achieved by twelve weeks post surgery.
Both cases returned to
unrestricted work at 6 and 7 weeks. Neither reported functional deficits at
discharge. DISCUSSION: Outcomes in 2 cases involving multiple digit injuries
exceeded those previously reported for ET zone III-IV repairs. CONCLUSIONS:
Relative motion orthoses can be adapted and applied to multi-finger injuries,
eliminating the need for multiple, bulky or functionally-limiting orthoses.
LEVEL OF EVIDENCE: 4.
CI - Copyright (c) 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS