SIMPLIFIED FUNCTIONAL SPLINTING AFTER EXTENSOR TENORRHAPHY

The medical records of 22 patients who had a total of 61 simple or com plex lacerations of finger, thumb, and wrist extensor tendons repaired in zones V-VIII (thumb zones TIII-TV) were reviewed. By 7 days after surgery, custom-molded splints were applied to hold the patients' wris ts extended (approximately 30 degrees) and the metacarpophalangeal (MP ) joints flexed slightly (20 degrees-30 degrees), leaving the interpha langeal (IF) joints free. If thumb tenorrhaphies were done, the thumb carpometacarpal and MP joints were included and splinted in neutral (0 degrees extension) position. Patients performed active IP joint range of motion (ROM) exercises as instructed. At a mean follow-up period o f 4.5 months (range, 1.5-12 months), there were no residual impairment s that interfered with patients' activities of daily living or prevent ed their return to preinjury employment status; 19 of 22 patients (86% ) had good or excellent results, based on objective criteria of active motion. There were no tenorrhaphy failures. The results support the c oncept of functional splinting techniques, which allow early active IP joint ROM while protecting the repaired tendons, thus resulting in le ss joint stiffness than older methods of static splinting without bein g as complicated and labor-intensive as dynamic splinting.