ASHT flexor tendons

Question 1

what factors increase the work required for active flexion?

Answer 1

Surface friction,
bulk of the repaired tendon,
bulk of the dressing,
tendon adhesions,
edema,
joint stiffness,
soft tissue resistance,
resistance of the antagonistic muscles (extensors)

Question 2

what is the goal for rehab exercises after flexor tendon repair?

Answer 2

LEAST amount of force, GREATEST amount of excursion

Question 3

what are the flexor tendon repair zones?

Answer 3

1- FDP primary repair
2- MPs to P2 includes FDP/FDS splint
3- A1 pulley>retinaculum, no retinacular system, more space
4- Less space all within carpal tunnel
5- tendon adhesions less frequent due to tissue mobility 2 and 4 have highest risk for adhesions

Question 4

what is Groth progressive forces pyramid?

Question 5

who are flexion immobilization protocols used for?

Answer 5

Complete immobilization for 3-4 weeks then start passive and active motion:

Children under 12, cognitively impaired, potential nonadherence. OLD news

Question 6

Early passive motion flexion vs. extension

Answer 6

Passive flexion pushes tendon proximally, active extension pulls distally. Can be manual or with dynamic traction

Question 7

Passive protocol, modified Duran

Answer 7

Dorsal block orthosis, passive protected digital extension. MODIFIED DURAN adds passive flexion + active extension in orthosis. 3-5mm glide. HOLD PIP in flexion and passive extend DIP. HOLD MP in flexion passive extend PIP.

Question 8

Kleintert

Answer 8

Dorsal block splint with rubber band traction> PIP and DIP flexion contractures + active extension

Question 9

Indiana Protocol

Answer 9

Synergistic motion place and hold. 2 splints: dorsal block + hinged orthosis. exercise: 1. gentle passive 2. apply hinged orthosis for 25 reps hourly

Question 10

True Active Motion St. John protocol

Answer 10

1. dorsal block wrist in extension, 2 PROM warm up 3. Active motion mid range *initiate movement at DIP 4. hand-based orthosis at 2 weeks (max 45 wrist extension)

Question 11

What are the benefits of WALANT procedure?

Answer 11

Wide Awake Local Anesthesia No Tourniquet. 1. less rupture 2. fewer tenolysis 3. more confidence 4. 90 min education for pt 5. can make decisions in OR

Question 12

what is Manchester short splint?

Answer 12

hand based dorsal block that allows wrist extension up to 45 degrees.

Question 13

Potential tendon issues

Answer 13

Rupture, Gapping (triggering), Adhesions