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This study compares two methods of post-operative immobilization after surgical repair (tenorrhaphy) of extensor tendons in the fingers. Patients were randomly assigned to receive either a standard plaster splint or an alternative splinting method that allows controlled finger movement (ICAMS). The main goal was to determine which method leads to better recovery in terms of finger mobility, grip strength, pain, and patient comfort.
Extensor tendon injuries of the hand are commonly treated with immobilization for 4-6 weeks using a plaster splint in the intrinsic plus position. However, prolonged immobilization may lead to tendon adhesions, joint stiffness, and delayed return to function. This randomized controlled clinical trial evaluated the efficacy of an immediate controlled active motion splinting protocol (ICAMS) compared to classic immobilization (CI) following extensor tendon tenorrhaphy in zones IV, V, and VI. Thirty patients were randomly assigned to either group. Functional outcomes were assessed at 4 and 6 weeks post-injury, including grip strength, joint range of motion, pain (VAS), Quick-DASH score, and patient satisfaction. The ICAMS group showed significantly better results in all main functional parameters. These findings support the use of early active motion protocols in selected cases of extensor tendon injury to enhance recovery and patient comfort.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ICAMS Group | Experimental | Participants received immediate controlled active motion splinting (ICAMS) after extensor tendon tenorrhaphy. The ICAMS protocol included a daytime yoke splint, which maintained the injured finger in 20° more extension than adjacent fingers, and a nocturnal intrinsic plus static splint. The protocol was maintained for 4 weeks post-surgery |
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| Classic Immobilization Group | Active Comparator | Participants received standard immobilization with a plaster splint in the intrinsic plus position following extensor tendon tenorrhaphy. The immobilization was maintained continuously for 4 weeks. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ICAMS Splinting Protocol | Device | The ICAMS protocol consisted of a daytime yoke splint maintaining the injured finger in 20° more extension than adjacent fingers, combined with a nocturnal static splint in the intrinsic plus position. The splinting was applied for 4 weeks following extensor tendon tenorrhaphy. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Grip Strength of the Injured Hand | Grip strength was measured using a JAMAR manual dynamometer to evaluate functional recovery after extensor tendon tenorrhaphy. Measurements were taken at 4 and 6 weeks post-injury. | 4 and 6 weeks after injury |
| Measure | Description | Time Frame |
|---|---|---|
| Change in MCP Joint Flexion | Active flexion of the metacarpophalangeal (MCP) joints of the injured finger was measured to assess recovery of joint mobility. | 4 and 6 weeks after injury |
| Pain Intensity (VAS Score) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Miguel Cela-López, MD | Sergas | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHUVI Hospital (Complejo Hospitalario Universitario de Vigo) | Vigo | Pontevedra | 36312 | Spain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41761624 | Derived | Cela-Lopez M, Mendez-Perez C, Dominguez-Prado DM, Garcia-Reza A, Alvarez-Alvarez L, Perez-Alfonso E, Castro-Menendez M. Relative Motion Extension Orthosis Versus Classic Immobilization in Extensor Tendon Repairs (Zones IV-VI of the Hand): A Randomized Controlled Trial. Hand (N Y). 2026 Feb 27:15589447261422483. doi: 10.1177/15589447261422483. Online ahead of print. |
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| ID | Term |
|---|---|
| D006230 | Hand Injuries |
| D013708 | Tendon Injuries |
| ID | Term |
|---|---|
| D014947 | Wounds and Injuries |
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| ID | Term |
|---|---|
| D013165 | Splints |
| ID | Term |
|---|---|
| D016267 | External Fixators |
| D009984 | Orthopedic Fixation Devices |
| D009983 | Orthopedic Equipment |
| D013523 | Surgical Equipment |
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Randomized, single-blind, parallel-group design comparing ICAMS versus classic immobilization following extensor tendon tenorrhaphy
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This was a single-blind study. The outcomes assessor was blinded to group allocation. Participants and care providers were not blinded due to the visible nature of the splints.
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| Classic Plaster Immobilization | Device | Participants received a classic plaster splint in the intrinsic plus position worn continuously for 4 weeks following extensor tendon tenorrhaphy. |
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Pain was evaluated using a 10-point Visual Analog Scale (VAS) at both follow-up visits.
| 4 and 6 weeks after injury |
| Quick-DASH Score | Upper limb disability and function were assessed using the Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) questionnaire. | 4 and 6 weeks after injury |
| Patient Comfort With Immobilization | Patients rated their comfort with the splint using a yes/no response at 4 weeks post-treatment. | 4 and 6 weeks after injury |
| Patient Satisfaction With Treatment Outcome | Patients reported overall satisfaction with the treatment using a yes/no response. | 4 and 6 weeks after injury |
| D004864 |
| Equipment and Supplies |
| D053831 | Surgical Fixation Devices |