[Operative procedure for repair of the dorsal aponeurosis promoting early active motion].
OBJECTIVE
To describe our method of treatment for extensor tendon laceration at the level of the distal and proximal interphangeal joint with early active motion following a special tendon suture and to evaluate the outcome.


METHODS
In a retrospective study the results of 35 patients with 35 extensor tendon lacerations in zone 1 and 2, in whom the postoperative treatment consisted of immobilisation, were compared with the results of 24 patients, in whom 24 extensor tendon lacerations in zone 1 and 2 were treated with early active motion following operative treatment. In addition, the outcome following immobilisation after operative treatment of 54 patients with 57 extensor tendon lacerations in zone 3 was compared to the outcome of 61 patients, who had undergone early active motion following operative treatment, with 65 extensor tendon lacerations in zone 3. In patients, treated with early active motion, a special type of tendon suture was carried out. The outcome was ranked according to a scoring system developed by us.


RESULTS
In extensor tendon laceration in zone 1 and 2 following active early motion there were 62.5 % excellent, 20.8 % good, 12.5 % satisfactory, and 4.2 % unsatisfactory results. In patients with extensor tendon lacerations in zone 1 and 2, in whom the postoperative treatment consisted of immobilisation, 45.7 % excellent, 22.9 % good, 20 % satisfactory, and 11.4 % unsatisfactory results were found. Following early active motion in patients with zone 3 extensor tendon laceration, there were 70.8 % excellent, 15.4 % good, 9.2 % satisfactory, and 4.6 % unsatisfactory results. After postoperative immobilisation 59.7 % excellent, 14 % good, 12.3 % satisfactory, and 14 % unsatisfactory results were found. For extensor tendon laceration in zone 1 and 2, there was a tendency to much better results in the early active motion group. However, the differences in the outcome of the two treatment groups were not statistically significant. There were significantly more good and excellent results and less unsatisfactory results in zone 3 extensor tendon lacerations following early active motion than following immobilisation.


CONCLUSIONS
This data suggests that patients benefit by early active motion rehabilitation protocol following operative treatment for extensor tendon lacerations in zone 1 to 3. Our special tendon suture proved in the practice well.
Zlatkov
T P
TP
Abteilung für Orthopädie und Traumatologie, Krankenhaus für aktive Behandlung, Dobritsch, Bulgarien. timotey_zlatkov@hotmail.com
D000293:Adolescent; D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000534:rehabilitation / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007103:Immobilization; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011182:Postoperative Care; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013536:Suture Techniques; D013708:Tendon Injuries / Q000534:rehabilitation / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome