Variation in patient information and rehabilitation regimens after flexor tendon repair in the United Kingdom
File(s)
Author(s)
Newington, Lisa
Lane, Jennifer CE
Holmes, David GW
Gardiner, Matthew D
Type
Journal Article
Abstract
Introduction
There is clinical uncertainty regarding the optimal method of rehabilitation following flexor tendon repair. Many splint designs and rehabilitation regimens are reported in the literature; however, there is insufficient evidence to support the use of any one regimen. The aim of this study was to describe rehabilitation guidelines used in the United Kingdom (UK) following zone I/II flexor tendon repair.
Methods
Using a cross-sectional design, hand units in the UK were invited to complete a short survey and to upload their flexor tendon rehabilitation guidelines and patient information material. Approval was granted by the British Association of Hand Therapists. Data were extracted in duplicate, using a pre-piloted form, and analysed using descriptive statistics.
Results
Thirty-five hand units responded (21%), providing 52 treatment guidelines. Three splinting regimens were described, and all involved early active mobilisation: (i) long dorsal-blocking splint (DBS); (ii) short DBS; and (iii) relative motion flexion splint. Duration of full-time splint wear ranged from 4 to 6 weeks. There were variations in splint design and composition of home exercise programmes, particularly for the long DBS. Where reported, recommended return to driving ranged from 8 to 12 weeks, and return to light work activities ranged from 5 to 10 weeks.
Discussion
Treatment guidelines varied across UK hand therapy departments, suggesting that patients receive differing advice about how to protect, move and use their hand after zone I/II flexor tendon repair. The disparity in splint wear duration, home exercise frequency and prescribed functional restrictions raises potential financial and social implications for patients. Future research should explore rehabilitation burden in addition to clinical outcomes.
There is clinical uncertainty regarding the optimal method of rehabilitation following flexor tendon repair. Many splint designs and rehabilitation regimens are reported in the literature; however, there is insufficient evidence to support the use of any one regimen. The aim of this study was to describe rehabilitation guidelines used in the United Kingdom (UK) following zone I/II flexor tendon repair.
Methods
Using a cross-sectional design, hand units in the UK were invited to complete a short survey and to upload their flexor tendon rehabilitation guidelines and patient information material. Approval was granted by the British Association of Hand Therapists. Data were extracted in duplicate, using a pre-piloted form, and analysed using descriptive statistics.
Results
Thirty-five hand units responded (21%), providing 52 treatment guidelines. Three splinting regimens were described, and all involved early active mobilisation: (i) long dorsal-blocking splint (DBS); (ii) short DBS; and (iii) relative motion flexion splint. Duration of full-time splint wear ranged from 4 to 6 weeks. There were variations in splint design and composition of home exercise programmes, particularly for the long DBS. Where reported, recommended return to driving ranged from 8 to 12 weeks, and return to light work activities ranged from 5 to 10 weeks.
Discussion
Treatment guidelines varied across UK hand therapy departments, suggesting that patients receive differing advice about how to protect, move and use their hand after zone I/II flexor tendon repair. The disparity in splint wear duration, home exercise frequency and prescribed functional restrictions raises potential financial and social implications for patients. Future research should explore rehabilitation burden in addition to clinical outcomes.
Date Acceptance
2022-03-08
Citation
Hand Therapy, 27 (2), pp.175899832210896-175899832210896
ISSN
1758-9983
Publisher
SAGE Publications
Start Page
175899832210896
End Page
175899832210896
Journal / Book Title
Hand Therapy
Volume
27
Issue
2
Copyright Statement
© 2022 The Author(s). The final, definitive version of this paper has been published in Hand Therapy
2022, Vol. 0(0) 1–9 by Sage Publications Ltd. All rights reserved. It is available at: https://doi.org/10.1177/17589983221089654
2022, Vol. 0(0) 1–9 by Sage Publications Ltd. All rights reserved. It is available at: https://doi.org/10.1177/17589983221089654
Identifier
https://journals.sagepub.com/doi/10.1177/17589983221089654
Subjects
Science & Technology
Life Sciences & Biomedicine
Rehabilitation
treatment guidelines
flexor tendon repair
return to work
return to driving
SPLINT
1103 Clinical Sciences
Publication Status
Published online
Date Publish Online
2022-04-06