Finger flexor tendon injuries repaired surgically followed by an early active motion program: A prospective cohort study of clinician- and patient-reported outcomes.

BACKGROUND

Finger flexor tendon injuries are usually surgically repaired followed by early active motion rehabilitation. Studies have focussed on clinician-reported outcomes after these injuries.

PURPOSE: To measure clinician- and patient-reported outcomes after finger flexor tendon repair.

STUDY

DESIGN

Prospective cohort study.

METHODS

Adult patients with traumatic, finger flexor tendon injuries who underwent surgical repair were recruited. An individualized, early active motion rehabilitation program was provided, including an orthosis, progressive active/passive range of motion (ROM) and strengthening exercises. Clinician-reported outcomes, namely total active motion (TAM), Strickland-Glogovac ROM, flexor/extensor deficits, and grip strength, were recorded 3 months post-injury. Patient-reported outcomes, namely the Michigan Hand Questionnaire (MHQ) and 36-item Short Form Health Survey (SF-36), were measured at baseline (pre-injury) and 3 months, and return to work/leisure and level of adherence at 3 months.

RESULTS

Data from 32 participants (20 male, mean age 39.8 years, 61 repaired tendons) were analyzed. At 3 months post-injury, mean ROM was 83.5% and 73.8%, compared to the unaffected hand, for total active motion and Strickland-Glogovac ROM, respectively, and grip strength 68.4%. All MHQ scores were statistically significantly worse at 3 months compared to pre-injury (p ≤ 0.012), as were the physical role limitations and physical component summary scores of the SF-36 (p ≤ 0.023). All participants (100.0%) had returned to work by 3 months, and virtually all (96.6%) to leisure activities, although not always at pre-injury levels. The number of digits involved statistically significantly affected Strickland-Glogovac ROM (p ≤ 0.049), flexor deficit (p = 0.042) and SF-36 summary and total scores (p ≤ 0.049). The number of tendons involved statistically significantly affected flexor deficit (p = 0.042). Participant's adherence statistically significantly affected MHQ total score (p = 0.028).

CONCLUSIONS

The use of patient-reported outcomes, in addition to clinician-reported outcomes, provided deeper insight into patients' perceptions of their recovery after flexor tendon injury.