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

Abstract

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.