Evaluation of Rehabilitation of Surgically Repaired Flexor Hand Tendons and Ultrasonographic Follow up of Their Healing
Journal of Advances in Medicine and Medical Research,
Objectives: To evaluate the role of early rehabilitation of surgically repaired flexor hand tendons in improvement of clinical outcome and the role of musculoskeletal ultrasound in follow up of their healing.
Patients and methods: Thirty patients with 31 repaired flexor tendons. Assessment was done after 2nd, 4th,8th and 12th weeks of rehabilitation by visual analogue scale (VAS), total active motion of injured fingers (TAM), grip strength, hand assessment tool (HAT) score and ultrasound (US).
Results: There was a significant development in pain assessed by VAS, TAM, grip strength and HAT score of the affected hand (p<0.001). Ultrasonographic assessment of healing flexor tendons showed significant improvement in defect size, thickness, vascularity, echogenicity and margination. There was positive correlation between margination of healing flexor tendon with VAS, hand grip and HAT score.
Conclusions: Application of proper rehabilitation programs has a great impact on improving the functional outcome after surgical repair of flexor hand tendons. High-frequency ultrasound is used to follow up tendon healing after surgical repair and to assess the state of tendon repair in relation to clinical result.
- Musculoskeletal ultrasound
- hand assessment tool
- rehabilitation of repaired flexor hand tendons.
How to Cite
Ghosh S, Sinha RK, Datta S, Chaudhuri A, Dey C, Singh A. A study of hand injury and emergency management in a developing country. Int J Crit Illn Inj Sci. 2013 ;3(4):229-234.
Schöffl V, Heid A, Küpper T. Tendon injuries of the hand. World J Orthop. 2012;3:62–69.
4.Tang JB. Tendon injuries across the world: treatment. Injury. 2006;37:1036-1042.
Smith J, Finnoff J. Diagnostic and interventional musculoskeletal ultrasound: Part 2. Clinical applications. PM&R. 2009; 1:162-177.
Lund AT. Flexor tendon rehabilitation: a basic guide. Operat Tech Plast Reconstr Surg. 2000;7:20-24.
Gordon GA. Designed electromagnetic pulsed therapy: Clinical applications. J Cell Physiol 2007; 212:579-582.
Sibtain F, Khan A, Shakil-Ur-Rehman S. Efficacy of Paraffin Wax Bath with and without joint mobilization techniques in rehabilitation of post-traumatic stiff hand. Pak J Med Sci. 2013;29:647-650.
Kahl C and Cleland JA. Visual analogue scale, numeric pain rating scale and the McGill Pain Questionnaire: an overview of psychometric properties. Phys Ther Rev. 2005;10:123-128.
Galanakis I, Aligizakis A, Katonis P, Vavouranakis H, Stergiopoulos K, Hadjipavlou A. Functional evaluation after primary flexor tendon repair in zone II. Acta Orthop Belg. 2003;69(3):252-6.
Pujianita L, Prabowo T, Prananta MS. Prediction of Jamar Grip Strength Value Using Modified Aneroid Spyhgmomanometer Cuff Method. Int. J. Integr. Health Sci. 2017;5:1-7.
12.Naidu SH, Panchik D, Chinchilli VM. Development and validation of the hand assesment tool. J Hand Ther. 2009; 22:250-256.
Bűhler M, Johnson G and Meikle G. Longitudinal in vivo ultrasound observations of the surgically repaired zone II flexor digitorum profundus tendon. Ultrasound Med Biol. 2015;41:3018-3022.
Desai B, Makwana H, Shah D ,Patei P. Epidemiology of hand injuries in adults presenting to a tertiary trauma care centre: A descriptive study. Int. J. Orthop. Sci. 2018;4:434-438.
Howell JW and Peck F. Rehabilitation of flexor and extensor tendon injuries in the hand: current updates. Injury. 2013; 44:397-402.
Baz A, Hussien A, Samad H, El-Azizi H. Diagnostic performance of high-resolution ultrasound in pre-and postoperative evaluation of the hand tendons injuries. Egypt J Radiol Nucl Med. 2021;52:1- 10.
Rrecaj S, Martinaj M, Murtezani A, Ibrahimi-Kaçuri D, Haxhiu B, Zatriqi V. Physical therapy and splinting after flexor tendon repair in zone II. Med Arch. 2014;68(2):128-31.
Kitis PT, Buker N and Kara IG. Comparison of two methods of controlled mobilisation of repaired flexor tendons in zone 2. Scand J Plast Reconstr Surg Hand Surg. 2009;43(3):160-165.
Libberecht K, Lafaire C and Van Hee R. Evaluation and functional assessment of flexor tendon repair in the hand. Acta Chir Belg. 2006;106:560-565.
Thomopoulos S, Parks WC, Rifkin DB, Derwin KA. Mechanisms of tendon injury and repair. J Orthop Res. 2015;33(6):832-9.
James R, Kesturu G, Balian G, Chhabra AB. Tendon: biology, biomechanics, repair, growth factors, and evolving treatment options. J Hand Surg Am. 2008;33(1):102-12.
Sharma P and Maffulli N. Biology of tendon injury: healing, modeling and remodeling. J Musculoskelet Neuronal Interact. 2006;6:181-190.
Puippe GD, Lindenblatt N, Gnannt R, Giovanoli P, Andreisek G, Calcagni M. Prospective morphologic and dynamic assessment of deep flexor tendon healing in zone II by high-frequency ultrasound: preliminary experience. AJR Am J Roentgenol. 2011;197(6):W1110- 7.
Abstract View: 129 times
PDF Download: 56 times