Two case reports-Use of relative motion orthoses to manage extensor tendon zones III and IV and sagittal band injuries in adjacent fingers.

Abstract

STUDY DESIGN:

Case report.

INTRODUCTION:

Injuries to adjacent fingers with differing extensor tendon (ET) zones and/or sagittal band pose a challenge to therapists as no treatment guidelines exist.

PURPOSE OF THE STUDY:

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.

• Authors: Melissa J Hirth, Julianne W Howell, Lisa O'Brien
• Journal: Journal of hand therapy : official journal of the American Society of Hand Therapists (J Hand Ther) 2017 Oct - Dec Vol. 30 Issue 4 Pg. 546-557 ISSN: 1545-004X [Electronic] United States
• PMID: 28988676 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Topics

• Adolescent
• Exercise Therapy (methods)
• Female
• Finger Injuries (diagnosis, rehabilitation, surgery)
• Humans
• Injury Severity Score
• Male
• Middle Aged
• Occupational Therapy (methods)
• Orthotic Devices (statistics & numerical data)
• Postoperative Care (methods)
• Range of Motion, Articular (physiology)
• Recovery of Function
• Tendon Injuries (diagnosis, rehabilitation, surgery)
• Treatment Outcome