title: Comparison of Shoulder Management Strategies after Stage I of Fingertip Skin Defect Repair with a Random-Pattern Abdominal Skin Flap.
abstract: BACKGROUND
  In the absence of scientific evidence regarding the effectiveness of shoulder management strategies after stage I of fingertip reconstruction, the purpose of this study was to compare the clinical outcomes of various rehabilitation procedures.
  
  
  METHODS
  Patients who underwent fingertip reconstruction with a random-pattern abdominal skin flap between March 2007 and February 2013 were enrolled in the study (n=95). Thirty performed only active exercise (group A), 29 performed only passive exercise (group B), and 32 received a combination of active exercise and pulsed electromagnetic field (PEMF) (group C). The mean age at the time of treatment was 30.2 years in group A, 29.6 years in group B, and 31.8 years in group C.
  
  
  RESULTS
  At the final follow-up, there were significant differences between group A and B in terms of Constant score (P=.001), VAS (P=.047), forward flexion of the shoulder (P=0.049), and muscle strength with forward flexion and external rotation (P=0.049 and P=0.042, respectively). A higher Constant score was observed in group C compared to group A, and although there were no differences in the other evaluations between groups A and C, a trend toward better function of the shoulder was demonstrated in group C.
  
  
  CONCLUSIONS
  The most important findings in our study are that a combination of active exercise and PEME produces superior patient-reported outcomes regarding relief of shoulder signs and symptoms. Given the limitations of this study, better-designed studies with large sample sizes and long-term follow-up are required.
authors.affiliation: Department of Orthopedics, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).
authors.forename: Feng
authors.initials: F
authors.lastname: Zhao
authors.affiliation: Department of Hand Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).
authors.forename: Wei
authors.initials: W
authors.lastname: He
authors.affiliation: Department of Orthopedics, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).
authors.forename: Guoping
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).
authors.forename: Shaojun
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Hand Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).
authors.forename: Kunlun
authors.initials: K
authors.lastname: Yu
authors.affiliation: Department of Hand Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).
authors.forename: Jiangbo
authors.initials: J
authors.lastname: Bai
authors.affiliation: Department of Hand Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, China (mainland).
authors.forename: Hongjuan
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Hand Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).
authors.forename: Dehu
authors.initials: D
authors.lastname: Tian
mesh_terms: D000293:Adolescent; D000328:Adult; D004574:Electromagnetic Fields; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005385:Fingers / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D026741:Physical Therapy Modalities; D011184:Postoperative Period; D016059:Range of Motion, Articular / Q000502:physiology; D012046:Rehabilitation / Q000379:methods; D012189:Retrospective Studies; D012782:Shoulder / Q000502:physiology; D012785:Shoulder Joint / Q000503:physiopathology*; D012867:Skin; D013524:Surgical Flaps / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult