Article

Controversy exists as to which
rehabilitation protocol provides the best outcomes for patients after surgical
repair of the extensor tendons of the hand. PURPOSE OF THE STUDY: To determine
which rehabilitation protocol yields the best outcomes with respect to range of
motion and grip strength in extensor zones V-VIII of the hand. METHODS: A
comprehensive literature review and assessment was undertaken by two independent
reviewers. Methodological quality of randomized controlled trials and cohort
studies was assessed using the Scottish Intercollegiate Guidelines Network scale.
RESULTS: Seventeen articles were included in the final analysis (kappa=0.9). From
this total, seven evaluated static splinting, 12 evaluated dynamic splinting, and
four evaluated early active splinting. Static splinting yielded "excellent/good"
results ranging from 63% (minimum) to 100% (maximum) on the total active motion
(TAM) classification scheme and TAM ranging from 185 degrees (minimum) to 258
degrees (maximum) across zones V-VIII. Dynamic splinting studies demonstrated a
percentage of "excellent/good" results ranging from 81% (minimum) and 100%
(maximum) and TAM ranging from 214 degrees (minimum) and 261 degrees (maximum).
Early active splinting studies showed "excellent/good" results ranging from 81%
(minimum) and 100% (maximum). Only one study evaluated TAM in zones V-VIII, which
ranged from 160 degrees (minimum) and 165 degrees (maximum) when using two
different early active modalities. CONCLUSIONS: The available level 3 evidence
suggests better outcomes when using dynamic splinting over static splinting.
Additional studies comparing dynamic and early active motion protocols are
required before a conclusive recommendation can be made. LEVEL OF EVIDENCE: 2.
CI - Copyright (c) 2011 Hanley & Belfus. Published by Elsevier Inc. All rights
reserved.

Langue : ANGLAIS