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

2017

Hirth, Melissa J

Howell, Julianne W

O'Brien, Lisa

Case report

Central slip

Extensor tendon

Orthoses

Relative motion

Sagittal band

Journal Article

10.1016/j.jht.2017.04.006

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.

link

Journal of hand therapy 2017; 30(4): 546-557

Journal of hand therapy : official journal of the American Society of Hand Therapists