Article

There exist numerous combinations
of orthoses and motion protocols for the treatment of proximal extensor tendon
injuries. The purpose of this study was to determine the optimal
combination of motion protocol and orthotic treatment for the rehabilitation of
proximal extensor tendon injuries (zones IV-VIII). METHODS:
A systematic review
of English language randomized clinical trials and cohort studies investigating
extensor tendon rehabilitation from 1960 to 2016 was conducted in MEDLINE,
Embase, Cochrane, CINAHL, PEDro, and OTseeker. Outcomes of total active motion,
grip strength, return to work, patient attrition, and patient-reported outcomes
were compared. RESULTS: Eleven studies of predominantly average quality (1, low;
8, average; and 2, high) were included in the final review. Results were
difficult to compare due to differences in reporting. Early total active motion
and final grip strength were greater with dynamic extension orthoses (191 degrees
-214 degrees ; 35-38 kg/89% contralateral side) and relative motion orthoses (205
degrees -236 degrees ; 85%-95% contralateral side) compared to static orthoses
(79 degrees -202 degrees ; 23-34 kg/59% contralateral side). Four studies
excluded patients who did not follow up, and loss to follow-up was 12%-33% in the
other studies. Patient-reported outcomes were not comparable, as they were only
included in 3 studies, and each used a different assessment tool. CONCLUSION:
Average quality evidence supports the use of early active motion (EAM) as the
superior motion protocol, but optimal orthosis to deliver EAM could not be
determined. Prospective research should focus on patient-reported outcomes and
the design of orthoses that facilitate the use of the EAM. LEVEL OF EVIDENCE: 2a.
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Langue : ANGLAIS