title: Dynamic splinting with early motion following zone IV/V and TI to TIII extensor tendon repairs.
abstract: OBJECTIVE
  To investigate the influence of a dynamic splinting protocol on outcomes of extensor tendon repairs.
  
  
  METHODS
  All patients in a prospectively collected database underwent extensor tendon repair by a single surgeon between 2004 and 2008. The inclusion criterion was simple extensor tendon repairs in zone IV and V in the fingers and zones TI to TIII in the thumb. The tendon repairs used a 4-strand core technique and running epitendinous suture. Within 7 days, each subject began using a dynamic extension splint during the day and a static extension splint at night. The extension splint allowed the patient to passively extend and actively flex the digits. After 3 weeks, the dynamic splint was discontinued and the patients were started on active digital motion. Static night splinting was continued for the next 3 weeks, after which time splinting was discontinued and strengthening was instituted. A total of 17 patients with 19 tendon lacerations met the inclusion criterion. There were 5 patients with lacerations of the thumb extensors and 12 patients with zone IV/V finger extensor tendon lacerations. The average time from injury to surgery was 11 days (range, 2-39 d). The follow-up was 43 to 215 days, with an average of 96 days.
  
  
  RESULTS
  A total of 16 patients achieved good or excellent results by 6 weeks according to our grading system. One patient had a fair result. There were no ruptures and no tenolysis surgeries performed.
  
  
  CONCLUSIONS
  Dynamic splinting resulted in generally good functional outcomes for extensor tendon laceration repairs in zone IV/V and TI to TIII, without complications.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Orthopaedic Hand Service, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Valentin
authors.initials: V
authors.lastname: Neuhaus
authors.forename: Grace
authors.initials: G
authors.lastname: Wong
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Russo
authors.forename: Chaitanya S
authors.initials: CS
authors.lastname: Mudgal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D022125:Lacerations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013165:Splints; D013708:Tendon Injuries / Q000601:surgery*; D013933:Thumb / Q000293:injuries* / Q000601:surgery*; D016896:Treatment Outcome