Functional outcome of zone 5 to zone 8 extensor tendon injuries of hand managed with early active mobilization following repair using a static splint: an observational study

Abstract

Background: Injuries to extensor tendons of the hand are underrepresented in the literature compared to flexor tendons. The concept of early mobilization following extensor tendon repair emerged as previous strategies of static immobilization lead to frequent adhesions and poor outcome. In our study we assessed the functional outcome of early active mobilization after extensor tendon repair using a static splint. Methods: In this observational study 42 patients with 48 extensor tendon severances of the hand from zone 5 to 8 were selected. Following repair, early active mobilization with a static splint was done and the functional outcomes were assessed using the Dargan criteria. Results: After mobilizing for 4 weeks, out of total 48 patients, 18 (43%) had good outcomes, 19 (45%) had fair and 5 patients (12%) had poor outcome. After 6 weeks 14 patients (33.3%) had excellent, 20 patients (48%) had good and 6 patients (14%) had fair outcomes whereas only one patient (2.4%) had poor outcome. This result was statistically significant with a p value of 0.000. Conclusions: Early active mobilization following extensor tendon repair from zone 5 to 8 prevents adhesion around the repair site, leads to better post-operative outcome and faster recovery. Using a static splint along with a patient friendly, easily comprehensible rehabilitation protocol offers results comparable to the use of dynamic splints and requires fewer post-operative follow ups. The static splints being cheap, easy to construct are financially beneficial to the patients.