Relative motion flexion splinting for the rehabilitation of flexor tendon repairs: A systematic review
File(s)
Accepted version
Author(s)
Newington, Lisa
Ross, Rachel
Howell, Julianne
Type
Journal Article
Abstract
Introduction: Relative motion splinting has been used successfully in the treatment of extensor tendon repairs and has
recently been applied in flexor tendon rehabilitation. The purpose of this systematic review was to identify articles
reporting use of relative motion flexion (RMF) splinting following flexor tendon repair and to examine indications for use
and clinical outcomes.
Methods: Seven medical databases, four trials registries and three grey literature sources were systematically searched
and screened against pre-specified eligibility criteria. Screening, data extraction and quality appraisal were independently
performed by two reviewers.
Results: A total of 12 studies were identified, of which three met the review eligibility criteria: one retrospective case
series; one cadaveric proof of concept study; and one ongoing prospective case series. The type of splint (including
metacarpophalangeal joint position and available movement), exercise programme, and zone of tendon injury varied
between studies. Both case series presented acceptable range of movement and grip strength outcomes. The prospective
series reported one tendon rupture and two tenolysis procedures; the retrospective series reported no tendon
ruptures or secondary surgeries.
Discussion: We found limited evidence supporting the use of RMF splinting in the rehabilitation of zones I-III flexor
tendon repairs. Further prospective research with larger patient cohorts is required to assess the clinical outcomes,
patient reported outcomes and safety of RMF splinting in comparison to other regimes. Application of the relative
motion principles to flexor tendon splinting varied across the included studies, and we suggest an operational definition
of relative motion in this context.
recently been applied in flexor tendon rehabilitation. The purpose of this systematic review was to identify articles
reporting use of relative motion flexion (RMF) splinting following flexor tendon repair and to examine indications for use
and clinical outcomes.
Methods: Seven medical databases, four trials registries and three grey literature sources were systematically searched
and screened against pre-specified eligibility criteria. Screening, data extraction and quality appraisal were independently
performed by two reviewers.
Results: A total of 12 studies were identified, of which three met the review eligibility criteria: one retrospective case
series; one cadaveric proof of concept study; and one ongoing prospective case series. The type of splint (including
metacarpophalangeal joint position and available movement), exercise programme, and zone of tendon injury varied
between studies. Both case series presented acceptable range of movement and grip strength outcomes. The prospective
series reported one tendon rupture and two tenolysis procedures; the retrospective series reported no tendon
ruptures or secondary surgeries.
Discussion: We found limited evidence supporting the use of RMF splinting in the rehabilitation of zones I-III flexor
tendon repairs. Further prospective research with larger patient cohorts is required to assess the clinical outcomes,
patient reported outcomes and safety of RMF splinting in comparison to other regimes. Application of the relative
motion principles to flexor tendon splinting varied across the included studies, and we suggest an operational definition
of relative motion in this context.
Date Issued
2021-09-01
Date Acceptance
2021-04-22
Citation
Hand Therapy, 2021, 26 (3), pp.102-112
ISSN
1369-9571
Publisher
British Association of Hand Therapists
Start Page
102
End Page
112
Journal / Book Title
Hand Therapy
Volume
26
Issue
3
Copyright Statement
© The Author(s) 2021. The final, definitive version of this paper has been published in Newington L, Ross R, Howell JW. Relative motion flexion splinting for the rehabilitation of flexor tendon repairs: A systematic review. Hand Therapy. June 2021 by Sage Publications Ltd. All rights reserved. It is available at: https://doi.org/10.1177/17589983211017584
Identifier
https://journals.sagepub.com/doi/10.1177/17589983211017584
Subjects
Science & Technology
Life Sciences & Biomedicine
Rehabilitation
Flexor tendon
rehabilitation
splint
orthosis
relative motion
systematic review
ZONE-II
IMMOBILIZATION
1103 Clinical Sciences
Publication Status
Published
Date Publish Online
2021-06-07