Methods of rehabilitation of fingers after the repair of flexor tendon injuries of first and second degree]

Post-operative rehabilitation of fingers after flexor tendon repair is the important part of therapy which considerably affects final result of the treatment. Method of dynamic traction splinting introduced by Kleinert in 1973, resulted in significantly improvement of final outcomes of repaired flexor tendons, particularly in zone II. Several other than Kleinert dynamic splinting rehabilitation programs were described in the paper. These methods are precisely designed protocols including mode and duration of immobilization of the fingers in the cast, daily range and frequency of finger moves and rate of restoration of the full range of motion. The following rehabilitation protocols were described: active flexion-active extension (Billericay and Belfast), active flexion-active extension using an internal profundus splinting, passive flexion-passive extension and combined regimen of controlled motion with dynamic traction splinting. The late results of the treatment using mentioned above rehabilitation protocols were compared, with respect to proportion of excellent and good results and rate of ruptures of repaired tendons in the course of rehabilitation. Combined regimen of controlled motion with dynamic traction splinting appeared to be superior than other presented methods. There was mentioned that Kleinert dynamic traction splinting, which is the most frequently used post-operative protocol after flexor tendon repairs in Poland, is not the only way of rehabilitation and that other presented methods give comparable results and may be used as an effective, alternative technique.