American Association for Hand Surgery
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Clinical Differences between Forearm Volar Static Orthosis and Relative Motion Orthosis after Extensor Tendon Repair: Randomized Equivalence Trial
Ruth Luttwak, MD1; Reuben Haber, MD2; Dan Hutt, MD2; Daniel Dreyfuss, MD2
1Rambam Health care Campus, Haifa, Israel; 2Rambam Health Care Campus, Haifa, Israel

Introduction Different rehabilitation regimens and orthoses may be used after extensor tendon repair, including static extension splints, and relative motion splints. There is currently no consensus regarding the method used, and there is no conclusive evidence of the superiority of one method over the other in the long-term follow-up. In our prospective study, we aimed to examine the clinical differences between these methods in the short and long term.
Methods Patients aged 18-70 with an extensor tendon laceration in zones 4-7 undergoing surgery for tendon repair were randomly assigned to either post-surgical relative motion orthosis (RMO) or static orthosis (SO). Patients were followed up after 2 and 5 months. We measured the total active motion (TAM) of each finger (2-5) and the grip strength in both hands. We calculated the injured TAM and grip strength relative to the uninjured hand with hand dominance consideration (referred to as TAM% and %grip strength, respectively). In addition, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire was filled out as well.
Results The RMO was found to have a higher injured finger TAM and TAM% after 2 and 5 months but without statistical significance. %grip strength was significantly higher in the RMO group after 2 months (P-value =0.002). The %grip strength was higher after 5 months as well, but no significance was noted. DASH score was lower for the RMO group both after 2 and 5 months of follow-up, yet without significance. Comparing results between follow-up at 2 and 5 months, showed improvement in the TAM and %TAM only when using the SO regimen.
Conclusions As seen previously, no significant difference was found between these rehabilitation protocols used in the short and long term. Although not statistically significant, the RMO regimen has faster improvement in grip strength and finger range of motion.


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