Comparison of Early Active and Passive Post-operative Mobilization

Objectives: Despite numerous studies, achieving the best outcome is challenging after flexor tendon repairs in zone 2. This study was done to test the hypothesis that immediate postoperative active mobilization will achieve similar outcomes to passive mobilization. Method: Fifty fingers in 38 patients with flexor tendon repair in zone 2 were enrolled in this trial. The patients were randomly assigned to two groups: Early active mobilization and Passive mobilization. They were assessed eight weeks post-operatively. Outcomes were defined using ‘Strickland’ and ‘Buck- Gramcko’ criteria. The analysis was done according to intention-to-treat principles, using imputation for missing data. Results: There were significant differences between the two groups (p < 0.001). According to Strickland criteria, the results were 80% ‘excellent and good’ and 20% ‘fair’ and ‘poor’ in the early active mobilization group. In the passive mobilization control group results were: 40% ‘excellent and good’ and 44% fair and 16% poor. Mean of total active mobilization was significantly greater in the early active mobilization group. Conclusion: The actively mobilized tendon underwent intrinsic healing without large gap formation. Increased ultimate range of motion confirmed that early active mobilization can be used after strong repair in zone two.