Early Active Motion Rehabilitation Versus Immobilisation For Thumb Extensor Tendon Repairs: A Review Of Two Case Studies

Abstract

Following positive outcomes reported in recent literature, early active motion within a static splint is now a recognised rehabilitation regime for finger extensor tendons. This paper discusses the available literature on thumb extensor tendon rehabilitation, and the justification for introducing early motion for this injury. The early active motion regime for the thumb extensor tendon used at our unit is described and compared against the traditional static splint regime. Two case studies are presented to illustrate the problems associated with these regimes and the patient outcomes achieved. Outcomes were analysed utilising Total Active Motion (Kleinert and Verdan 1983), Kapandji's opposition (1992) and White's assessment of tendon repair (1956). Both patients made a full, uncomplicated recovery after their thumb extensor tendon repair, but the patient who followed the Early Active Motion regime regained motion and light function sooner than the patient who underwent four weeks of immobilisation. This enabled an earlier discharge (eight rather that 12 weeks) and less therapy intervention overall. These are all factors that need to be considered when deciding upon which rehabilitation regime to use.