Publication:

Outcomes of early active mobilization after surgical repair of injured extensor tendon of hand and forearm

Background Extensor tendon injuries in the hand and forearm, if left untreated, can significantly impair backhand function. Timely and effective treatment is crucial. Recent evidence suggests that early active mobilization post-surgery yields better short-term outcomes, with less disparity in long-term results.

Methods This prospective observational study was conducted at the department of orthopedic surgery, BSMMU, Dhaka, Bangladesh, from March 2014 to August 2016, with a total of 40 patients.

Results The study evaluated the efficacy of early active mobilization following surgical repair of extensor tendon injuries in zones V-VIII of the hand and forearm. At 12 weeks post-surgery, 75% of patients reported no pain, increasing to 90% at 6 months and stabilizing at 85% by 12 months. Furthermore, 75% of patients regained a range of motion greater than 120 degrees at 6 months, with 60% maintaining this at 12 months. Notably, 90% of the patients maintained normal grip strength at both 6 and 12 months. Final assessments using the Mayo wrist score showed satisfactory outcomes for 70% of patients at 12 weeks, 90% at 6 months, and 95% at 12 months. The Dargan criteria echoed these positive results, with satisfaction rates of 80% at 12 weeks, 90% at 6 months, and 95% at 12 months. Complications were minimal, including superficial skin infections (5%), hypertrophic scars (10%), and tendon rupture (5%).

Conclusions The study concludes that early active mobilization, complemented by a simple static splint, facilitates faster recovery, full range of motion, improved grip strength, and earlier return to work in the early postoperative period.