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Passive Mobilization With Place and Hold Versus Active Motion Therapy After Flexor Tendon Repair: A Randomized Trial

  • Sara Chevalley
    Correspondence
    Corresponding author: Sara Chevalley, MD, MSc, Department of Hand Surgery, Sahlgrenska University Hospital, SE-431 80 Mölndal, Sweden.
    Affiliations
    Department of Hand Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden

    Department of Hand Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg
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  • Maria Tenfält
    Affiliations
    Department of Occupational Therapy and Physiotherapy, Hand Rehabilitation, Sahlgrenska University Hospital, Gothenburg, Sweden
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  • Martina Åhlén
    Affiliations
    Department of Hand Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden

    Department of Hand Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg
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  • Joakim Strömberg
    Affiliations
    Department of Hand Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden

    Department of Hand Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg

    Department of Surgery and Orthopedics, Alingsås Hospital, Alingsås, Sweden
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Published:February 18, 2022DOI:https://doi.org/10.1016/j.jhsa.2021.11.031

      Purpose

      Mobilization after flexor tendon repair in fingers has been a subject of debate for several years. Many hand surgery clinics have turned to early active mobilization. However, there is no strong scientific evidence suggesting that early active mobilization produces a better range of motion (ROM) than the Kleinert regimen when place and hold is added. Therefore, the purpose of this prospective randomized trial was to investigate whether active mobilization is superior to passive mobilization with place and hold after flexor tendon repair in the fingers. Our hypothesis was that patients who follow the active mobilization protocol have a better ROM than those who follow the passive protocol with place and hold.

      Methods

      Sixty-four patients with a flexor tendon injury in zone I or II were included. After surgery, randomization to undergo either active mobilization or passive mobilization with place and hold was performed. The patients were followed-up for 12 months using outcome measurements, including ROM, strength, rupture frequency, Disabilities of the Arm, Shoulder and Hand score, ABILHAND questionnaire, and performance on the Purdue Pegboard test.

      Results

      We were unable to find any significant difference between the 2 groups for any of the outcome measurements, ROM, grip strength, key pinch, rupture frequency, Disabilities of the Arm, Shoulder and Hand score, ABILHAND questionnaire, and performance on the Purdue Pegboard test.

      Conclusions

      The outcomes were equivalent for both the mobilization groups.

      Type of study/level of evidence

      Therapeutic I.

      Key words

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