Background: Flexor tendon injuries have been the subject of much of the hand surgery literature for several years. Surgical and therapeutic techniques are constantly evolving. Currently there is a trend toward multiple strand core suture techniques followed by early active mobilization. Rehabilitation after flexor tendon repair is critical in recovery. Early mobilization has been shown to be basic in improving the repaired tendon. Study Type: Narrative review of literature. Objective: Evaluating through scientific evidence in the literature what is the most effective protocol for rehabilitation of flexor tendon injuries in zone 2. Methods: Data were obtained by searching within databases such as PUBMED, COCHRANE and PEDRO. The most recent primary studies, systematic reviews, and literature reviews using key words were selected. Conclusions: The selected studies agree that a strong tendon suture and an early active mobilization protocol allow better outcomes. The multistrand technique, particularly a four-strand suture, provides strong tendon repair and almost completely prevents rupture. Post-surgical management must be early and ensure that healing time is respected. The patient should be aware that the most important and delicate phase for recovery is the first three weeks. Communication between the surgeon and therapist for the exchange of information and the choice of rehabilitation method is essential. The rehabilitation approach must be based on the tissue response of the subject. The literature continues to move toward protocols of early active mobilization and less immobilization of the wrist. However, it is important to recognize that there are still no well-designed intervention studies that define the optimal protocol. Key words: flexor tendon injury, flexor tendon rehabilitation protocols, flexor tendon rehabilitation, flexor tendon active protocol, flexor tendon active protocol zone 2.
Background: Le lesioni ai tendini flessori sono state oggetto di gran parte della letteratura in chirurgia della mano per diversi anni. Le tecniche di chirurgia e terapia sono in continua evoluzione. Attualmente si tende verso tecniche di sutura a passaggi multipli (multiple strand core suture) seguite da una mobilizzazione attiva precoce. La riabilitazione dopo riparazione del tendine flessore è fondamentale nel recupero. È stato dimostrato che la mobilizzazione precoce è basilare nel miglioramento del tendine riparato. Tipo di studio: Revisione narrativa della letteratura. Obiettivo: Valutare attraverso le evidenze scientifiche presenti in letteratura qual è il protocollo più efficace per la riabilitazione delle lesioni dei tendini flessori in zona 2. Metodi: I dati sono stati ottenuti attraverso la ricerca all’interno di banche dati come PUBMED, COCHRANE e PEDRO. Sono stati selezionati i più recenti studi primari, revisioni sistematiche e revisioni della letteratura usando key words. Conclusioni: Gli studi selezionati sono concordi nel dire che una sutura tendinea forte e un protocollo di mobilizzazione attiva precoce permettono migliori risultati. La tecnica multistrand, in particolare una sutura a quattro passaggi, garantisce una forte riparazione del tendine e impedisce quasi completamente la rottura. La gestione post-chirurgica deve essere precoce e garantire il rispetto dei tempi di guarigione. Il paziente deve essere a conoscenza che la fase più importante e delicata per il recupero è rappresentata dalle prime tre settimane. La comunicazione tra chirurgo e terapista per lo scambio di informazioni e la scelta della metodica riabilitativa è essenziale. L’approccio riabilitativo deve essere basato sulla risposta tissutale del soggetto. La letteratura continua a muoversi verso protocolli di mobilizzazione attiva precoce e minore immobilizzazione del polso. Nonostante ciò, è importante riconoscere che non esistono ancora studi di intervento ben disegnati che definiscono il protocollo ottimale. Key words: flexor tendon injury, flexor tendon rehabilitation protocols, flexor tendon rehabilitation, flexor tendon active protocol, flexor tendon active protocol zone 2.
LA RIABILITAZIONE DEI TENDINI FLESSORI IN ZONA 2: REVISIONE NARRATIVA DELLA LETTERATURA
MORBIDELLI, ELEONORA
2020/2021
Abstract
Background: Flexor tendon injuries have been the subject of much of the hand surgery literature for several years. Surgical and therapeutic techniques are constantly evolving. Currently there is a trend toward multiple strand core suture techniques followed by early active mobilization. Rehabilitation after flexor tendon repair is critical in recovery. Early mobilization has been shown to be basic in improving the repaired tendon. Study Type: Narrative review of literature. Objective: Evaluating through scientific evidence in the literature what is the most effective protocol for rehabilitation of flexor tendon injuries in zone 2. Methods: Data were obtained by searching within databases such as PUBMED, COCHRANE and PEDRO. The most recent primary studies, systematic reviews, and literature reviews using key words were selected. Conclusions: The selected studies agree that a strong tendon suture and an early active mobilization protocol allow better outcomes. The multistrand technique, particularly a four-strand suture, provides strong tendon repair and almost completely prevents rupture. Post-surgical management must be early and ensure that healing time is respected. The patient should be aware that the most important and delicate phase for recovery is the first three weeks. Communication between the surgeon and therapist for the exchange of information and the choice of rehabilitation method is essential. The rehabilitation approach must be based on the tissue response of the subject. The literature continues to move toward protocols of early active mobilization and less immobilization of the wrist. However, it is important to recognize that there are still no well-designed intervention studies that define the optimal protocol. Key words: flexor tendon injury, flexor tendon rehabilitation protocols, flexor tendon rehabilitation, flexor tendon active protocol, flexor tendon active protocol zone 2.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12075/628