Effects of Different Wrist Positions in Dorsal Blocking Orthoses After Flexor Tendon Repair

Effects of Different Wrist Positions in 3D-Printed Dorsal Blocking Orthoses on Clinical and Functional Outcomes After Zone I-II Flexor Tendon Repair: A Randomized Controlled Study

This randomized controlled study aims to compare the effects of three different wrist positions (30° extension, neutral, and 30° flexion) used in dorsal blocking orthoses during early active mobilization after zone I-II flexor tendon repair. A total of 54 patients will be randomly assigned into three groups. All participants will receive the same rehabilitation protocol. Clinical and functional outcomes including total active motion, pain, complications, functional status, and orthosis satisfaction will be evaluated at 6, 8, and 12 weeks by a blinded assessor.

Inclusion Criteria:

• Individuals aged 16 years and older
• Patients who underwent zone I or II flexor tendon repair using at least a four--strand suture technique
• Referral to physiotherapy within the first 10 days after surgery
• Eligibility for a controlled early active mobilization protocol
• Ability to understand and complete Turkish assessment questionnaires
• Adequate cognitive function (Montreal Cognitive Assessment score >21)
• Voluntary participation with written informed consent

Exclusion Criteria:

• Thumb tendon repairs
• Multiple or complex injuries (e.g., concomitant peripheral nerve injury, fractures requiring immobilization, joint dislocation, extensor tendon injury)
• Active infection
• Severe edema preventing orthosis use
• Dermatological conditions or allergies preventing orthosis application
• Systemic diseases that may affect rehabilitation (e.g., diabetes mellitus, -peripheral neuropathy, stroke, advanced rheumatoid arthritis)
• Pre-existing wrist pain or deformity prior to injury
• Inability to attend follow-up assessments
• Non-compliance with the home exercise program