Randomized Trial of Active vs Passive Splinting for Extensor Tendon Injuries in Zones IV to VI

Fundacin Biomedica Galicia Sur30 enrolled

Overview

This study compares two methods of post-operative immobilization after surgical repair (tenorrhaphy) of extensor tendons in the fingers. Patients were randomly assigned to receive either a standard plaster splint or an alternative splinting method that allows controlled finger movement (ICAMS). The main goal was to determine which method leads to better recovery in terms of finger mobility, grip strength, pain, and patient comfort.

Extensor tendon injuries of the hand are commonly treated with immobilization for 4-6 weeks using a plaster splint in the intrinsic plus position. However, prolonged immobilization may lead to tendon adhesions, joint stiffness, and delayed return to function. This randomized controlled clinical trial evaluated the efficacy of an immediate controlled active motion splinting protocol (ICAMS) compared to classic immobilization (CI) following extensor tendon tenorrhaphy in zones IV, V, and VI. Thirty patients were randomly assigned to either group. Functional outcomes were assessed at 4 and 6 weeks post-injury, including grip strength, joint range of motion, pain (VAS), Quick-DASH score, and patient satisfaction. The ICAMS group showed significantly better results in all main functional parameters. These findings support the use of early active motion protocols in selected cases of extensor tendon injury to enhance recovery and patient comfort.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Hand Injuries Tendon Injuries

Interventions

ICAMS Splinting ProtocolDEVICE

The ICAMS protocol consisted of a daytime yoke splint maintaining the injured finger in 20° more extension than adjacent fingers, combined with a nocturnal static splint in the intrinsic plus position. The splinting was applied for 4 weeks following extensor tendon tenorrhaphy.

Classic Plaster ImmobilizationDEVICE

Participants received a classic plaster splint in the intrinsic plus position worn continuously for 4 weeks following extensor tendon tenorrhaphy.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults aged 18 years or older * Patients from the CHUVI Health Area * Diagnosed with an acute, single, complete extensor tendon laceration in zones IV, V, or VI of the long fingers * Treated with primary tenorrhaphy * Provided signed informed consent * Agreed to attend follow-up visits and comply with the study protocol Exclusion Criteria: * More than one extensor tendon laceration in the same hand * Injuries involving the thumb * Tendon injuries with loss of substance * Associated injuries at the same level (e.g., bone fracture, nerve lesion) * Patients with cognitive impairment or inability to follow the protocol * Presence of other injuries or medical conditions that could interfere with assessment

Locations (1)

CHUVI Hospital (Complejo Hospitalario Universitario de Vigo)

Vigo, Pontevedra, Spain

Outcomes

Primary Outcomes

Change in Grip Strength of the Injured Hand

Grip strength was measured using a JAMAR manual dynamometer to evaluate functional recovery after extensor tendon tenorrhaphy. Measurements were taken at 4 and 6 weeks post-injury.