The Effects Of Training On Intrinsic Muscles Of Hand After Digital Flexor Tendon Repair: A Clinical Study

Objective: The purpose of this study is to analyze the effects of training on intrinsic muscles of hand after digital flexor tendon repair. The goal of this training was to achieve a normally gliding and functioning tendon.Methods: A one-year consecutive series of 60 patients (55 males and 5 females) aged between 19 and 57 years (mean, 31 years) with flexor tendon injuries and repairs in all zones of the hand were admitted to the Longgang district center hospital of ShenZhen and prospectively studied. Sixty patients with digital flexor tendon repair were randomly assigned into an experiment group (n=30) and a control group(n=30).Tendons were repaired by the modified Kessler's method using a 2-strand core suture with 4/0 nylon and a circumferential running suture with 6/0 nylon. A compression dressing was applied for 2 days together with a dorsal plaster slab to maintain the wrist in 40°flexion and extension block of the metacarpophalangeal joints at 90°. Patients in the experiment group were received intrinsic muscles training of hand, it includes metacarpus interossei training, dorsal interossei training, lumbrical muscles training, opponens pollicis training, adductor muscle training of thumb training, flexor hallucis brevis training and opposing muscle training of little finger. At the same time, patients in the experiment group were also received conventional rehabilitation. It includes flexor tendon passive mobilization, extensor tendon active mobilization, physical therapy (PT) and occupational therapy (OT). Patients in the control group were only received conventional rehabilitation.All the patients were followed-up 12 weeks. At the 4th, 8th week and the 12th weekend, the range of motion measurements of MPJ and IPJ were made with a standard finger goniometer. At the 12th weekend, Minnesota manual dexterity and Purdue pegboard were adopted to assessment after training on intrinsic muscles of hand.SPSS 13.0 for Windows software was used for all data manage- ment and analysis. In all cases, a level of 0.05 was considered to be statistically significant.Results: After three months intrinsic muscles training of hand, there were significant differences on hand Minnesota manual dexterity and Purdue pegboard between two groups (P<0.01). On the other hand, there were not significant differences on active range of motion between two groups (P>0.05).Conclusions: It is concluded that the intrinsic muscles training after digital flexor tendon repair can improve fine movement and coordination of hand.