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Abstract
The management of zone III extensor tendon injuries remains a challenging clinical
problem for both the surgeon and therapist. Current treatment protocols include prolonged
immobilization, controlled mobilization, or limited early dynamic splinting, but overall
results are often less than optimal. This retrospective study describes an alternative
treatment approach for acute central slip lacerations consisting of initial immobilization
of the PIP joint in absolute 0° extension for an average of 3.5 weeks followed by
active flexion of the PIP joint in a finger-based dynamic extension assist splint.
Therapy averaged approximately one visit weekly, and follow-up averaged 3.8 months.
Mean PIP joint extension was +1°, and mean PIP joint flexion was 109 degrees. Mean
DIP joint extension was −1 degree and mean DIP flexion was 67°. Mean total active
motion measured in composite fashion for the PIP and DIP joints was 175°. This treatment
approach produced excellent results, required infrequent therapy, and utilized only
finger-based splinting.
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References
- The Boutonniere deformity: a review of 101 patients with division of the central slip of the extensor expansion of the fingers.Bone Joint Surg. 1967; 4: 710-721
- Treatment of extensor tendon injuries of the hand.Can J Surg. 1973; 16: 366-375
- Management and rehabilitation of extensor tendon injuries.Orthop Clin North Am. 1983; 44: 811-826
- Boutonniere Deformity.in: Hunter JM Schneider LH Mackin EJ Tendon Surgery in the Hand. Mosby, St. Louis1987: 347-357
- Management of acute extensor tendon injuries.in: Hunter JM Schneider LH Mackin EJ Tendon Surgery in the Hand. Mosby, St. Louis1987: 336-343
- Extensor tendons: acute injuries.in: Green DP Operative Hand Surgery. Churchill-Livingstone, New York1988: 2045-2072
- Therapeutic management of extensor tendons.in: Hunter JM Schneider LH Mackin EJ Callahan AD Rehabilitation of the Hand. 3rd ed. Mosby, St. Louis1990: 492-514
- Long-term results of extensor tendon repair.J Hand Surg (Am). 1990; 15: 961-966
- Extensor tendon injuries.Orthop Clin North Am. 1992; 23: 141-148
- Extensor tendons: acute injuries.in: Green DP Operative Hand Surgery. 3rd ed. Churchill-Livingstone, New York1993: 1941-1945
- The digital extensor-flexor system.in: Converse JM Reconstructive Plastic Surgery. Saunders, Philadelphia1977: 3166-3175
- The extensor tendons.in: Hunter JM Schneider LH Mackin EJ Callahan AD Rehabilitation of the Hand. 2nd ed. Mosby, St. Louis1984: 324-352
- The extensor tendons.in: Hunter JM Schneider LH Mackin EJ Callahan AD Rehabilitation of the Hand. 2nd ed. Mosby, St. Louis1984: 353-357
- The extensor tendons.in: Hunter JM Schneider LH Mackin EJ Callahan AD Rehabilitation of the Hand. 3rd ed. Mosby, St. Louis1990: 470-491
- Injuries to the extensor mechanism of the hand.Ortho Clin North Am. 1970; 1: 343-347
- Lippincott, Philadelphia1979 Structural and Dynamic Bases of Hand Surgery. 2nd ed.
- Extensor surface injuries at the proximal interphalangeal joint.in: Bowers WH The Interphalangeal Joints. 3rd ed. Churchill-Livingstone, New York1987: 94-110
- Controlled mobilization of extensor tendon lacerations: study of 120 cases.Rev Chir Orthop. 1984; 70: 68-73
- Therapeutic management of extensor tendon injuries.Hand Clin. 1986; 2: 157-169
- Protected passive mobilization after suture of the extensor tendons of the hand: a survey of 120 cases.in: Hunter JM Schneider LH Mackin EJ Tendon Surgery in the Hand. Mosby, St. Louis1987: 344-348
- Clinical applications of controlled stress to the healing extensor tendon: a review of 112 cases.Phys Ther. 1990; 69: 1041-1049
- Early dynamic splinting for extensor tendon injuries.J Hand Surg. 1989; 14A: 72-76
- Early controlled active mobilization with dynamic splintage for treatment of extensor tendon injuries.J Hand Surg. 1990; 15A: 251-257
- Early mobilization of acute middle slip injuries.J Hand Surg. 1990; 15B: 404-406
- Results of acute zone III extensor tendon injuries treated with dynamic extension splinting.J Hand Surg. 1991; 16A: 1145-1150
- Early mobilization of extensor tendon laceration in zones III and IV. Society of Hand Therapists Scientific Session, Orlando, FLSeptember 1991
- Early controlled motion vs static splinting for zone III and IV extensor tendon laceration.J Hand Ther. 1994; 7: 232-236
- Extensor tendon injuries: presentation of a series of ninety-one cases.Ann Chir Main. 1985; 4: 55-63
- An analysis of factors that support early active short arc motion of the repaired central slip.J Hand Ther. 1992; 5: 187-201
- Early active short arc motion for the repaired central slip.J Hand Surg. 1994; 19A: 991-997
- Boutonniere deformity.in: Cramer LM Chase RA Symposium on the Hand. Mosby, St. Louis1971: 42-54
- Use of a retrograde tendon flap in repairing a severed extensor tendon in the PIP joint area.Plast Reconstr Surg. 1973; 51: 555-558
- Butterworths, London1966 Rehabilitation of the Hand. 2nd ed.
- Butterworth, Boston1973 Rehabilitation of the Hand. 3rd ed.
- Lively splints.Physiotherapy. 1967; 53: 371
- Spring-wire splinting of the proximal interphalangeal joint.in: Hunter JM Schneider LH Mackin EJ Callahan AD Rehabilitation of the Hand. 2nd ed. Mosby, St. Louis1984: 862-874
- Mosby, St. Louis1985 Clinical Mechanics of the Hand.
- Mosby, St. Louis1993 Clinical Mechanics of the Hand. 2nd ed.
- ASHT, Chicago1992 Clinical Assessment Recommendations. 2nd ed.
- Digital function following flexor tendon repair in zone II: a comparison of immobilization and controlled passive motion techniques.J Hand Surg. 1980; 5: 537-543
- The biomechanics of the interphalangeal joints.in: Bowers WH The Interphalangeal Joints. Churchill-Livingstone, New York1987: 21-54
- Extensor apparatus of the fingers.in: Hunter JM Schneider LH Mackin EJ Tendon Surgery in the Hand. Mosby, St. Louis1987: 319-324
- Intrinsic balance of the extensor system.in: Hunter JM Schneider LH Mackin EJ Tendon Surgery in the Hand. Mosby, St. Louis1987: 325-335
- Lippincott, Philadelphia1956 Surgery of the Hand. 3rd ed.
- Extensor apparatus of the fingers.in: Hunter JM Schneider LH Mackin EJ Tendon Surgery in the Hand. Mosby, St. Louis1987: 319-324
- Lippincott, Philadelphia1970 Bunnell's Surgery of the Hand. 5th ed.
Article info
Footnotes
*Presented at 18th Annual Meeting of the American Society of Hand Therapists, September 14–17, 1995, San Francisco, California. Best Clinical Paper Award.
Identification
Copyright
© 1996 Hanley & Belfus, Inc. Published by Elsevier Inc. All rights reserved.