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Title: Two case reports-Use of relative motion orthoses to manage extensor tendon zones III and IV and sagittal band injuries in adjacent fingers.
Austin Authors: Hirth, Melissa J ;Howell, Julianne W;O'Brien, Lisa
Affiliation: Department of Occupational Therapy, Austin Health, Heidelberg, Victoria, Australia
Department of Occupational Therapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, Australia
Malvern Hand Therapy, Malvern, Melbourne, Victoria, Australia
Samaritan Health Services, Samaritan Orthopaedics, Corvallis, OR, USA
Issue Date: 2017 2017-10-04
Publication information: Journal of hand therapy 2017; 30(4): 546-557
Abstract: Case report. Injuries to adjacent fingers with differing extensor tendon (ET) zones and/or sagittal band pose a challenge to therapists as no treatment guidelines exist. 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). 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. '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. Outcomes in 2 cases involving multiple digit injuries exceeded those previously reported for ET zone III-IV repairs. Relative motion orthoses can be adapted and applied to multi-finger injuries, eliminating the need for multiple, bulky or functionally-limiting orthoses. 4.
DOI: 10.1016/j.jht.2017.04.006
PubMed URL: 28988676
Type: Journal Article
Subjects: Case report
Central slip
Extensor tendon
Relative motion
Sagittal band
Appears in Collections:Journal articles

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