Early Intervention of Ultrasound and Active Mobilization Post Surgical Repair of Hand Flexor Tendon Laceration

Abstract
Background: Hand flexor tendon lacerations are very common and their surgical repair and postoperative rehabili-tation, particularly in zone II, present a formidable challenge to hand surgeons and therapists.
Purpose: The current study was conducted to investigate the effect of an early intervention of ultrasound and active mobilization on Interphalangeal (IP) joints active Range of Motion (ROM) affected by peritendinous adhesions post surgical repair of hand flexor tendon laceration.
Subjects and Methods: 30 male patients who underwent zone II flexor tendon primary direct four-strand repair tech-nique participated in this study. Their ages ranged from 20 to 35 years. They were selected from Cairo University Hospitals and divided randomly into three groups: Group (A) composed of 10 patients (15 operated digits) who received early Ultra-sound (US) therapy, and at the 4th and 6th post-operative weeks, the 2nd and 3rd phases of Early Active Mobilization (EAM) program were added respectively to the US therapy, Group (B) composed of 10 patients (16 operated digits) who received EAM, and Group (C) composed of 10 patients (16 operated digits) who received early intervention of US therapy and active mobilization. Patients in each group received the treatment (3 sessions/week) from the 3rd day post-operative till the end of the 6th week post-operative. Post surgical medical care (medications including analgesics and antibiotics, and wound dressings) was provided for all patients in each group. Finger goniometer was used to measure the IP joints active ROM of the operated digits at end of 3rd and 6th post-operative weeks.
Results: Group A, B, and C showed significant improve-ment in the active ROM at end of 6th week post-operative compared with that at end of 3rd week post-operative. There was a significant improvement in the active ROM at end of 3rd and 6th week post-operative of Group B compared with Group A. Group C showed significant improvement in the active ROM at end of 3rd and 6th week post-operative when compared to Group A but no significant improvement when compared to Group B.
Conclusion: Early intervention of US and active mobili-zation can improve the IP joints active ROM post flexor tendon repair significantly more than early US therapy alone but not significantly more than EAM alone.