Mn. Halikis et al., EFFECT OF IMMOBILIZATION, IMMEDIATE MOBILIZATION, AND DELAYED MOBILIZATION ON THE RESISTANCE TO DIGITAL FLEXION USING A TENDON INJURY MODEL, The Journal of hand surgery, 22A(3), 1997, pp. 464-472
This study employed a tendon injury model in chickens to determine the
effect of immobilization, immediate mobilization, and delayed mobiliz
ation on the energy required to fully flex the digit following surgica
l trauma to the tendon, as determined by measurement of the work of fl
exion (WOF). The immobilized group showed no increased WOF at 3 days c
ompared to the zero time control values, followed by significant incre
ased WOF at 1 week (36%), 2 weeks (41%), and 3 weeks (63%). The immedi
ate mobilization tendons showed an initial 36% rise in the work of fle
xion at 3 days, which increased to 40% at 1 week, and then decreased t
o baseline control values by 3 weeks. Delaying the period of mobilizat
ion until 5 days was not shown to significantly lower the peak WOF val
ue at 1 week, but delaying the period of mobilization until 3 days low
ered the peak WOF value at 1 week dramatically to 13%; both the 3- and
5-day delayed-mobilization groups returned to baseline WOF values by
3 weeks. From these data, it can be assumed that there is an early inc
rease in the work necessary for flexion of the injured operated digit
and tendon that is present in the immediately mobilized tendons at 3 d
ays and persists to 1 week and that does not appear until 1 week in th
e immobilized tendons; this rise in WOF can be blunted by delaying the
institution of mobilization.