Williams Nicola, Carey Madelaine, Stiller Kathy
Physiotherapy, Central Adelaide Local Health Network, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Physiotherapy, Central Adelaide Local Health Network, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
J Hand Ther. 2025 Feb 12. doi: 10.1016/j.jht.2024.12.011.
Finger flexor tendon injuries are usually surgically repaired followed by early active motion rehabilitation. Studies have focussed on clinician-reported outcomes after these injuries.
To measure clinician- and patient-reported outcomes after finger flexor tendon repair.
Prospective cohort study.
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.
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).
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.
手指屈肌腱损伤通常通过手术修复，随后进行早期主动活动康复治疗。研究主要关注这些损伤后临床医生报告的结果。
测量手指屈肌腱修复后临床医生和患者报告的结果。
前瞻性队列研究。
招募接受手术修复的创伤性手指屈肌腱损伤的成年患者。提供个性化的早期主动活动康复计划，包括矫形器、渐进性主动/被动活动范围（ROM）和强化训练。在受伤后3个月记录临床医生报告的结果，即总主动活动度（TAM）、Strickland-Glogovac活动度、屈伸肌功能缺陷和握力。在基线（受伤前）和3个月时测量患者报告的结果，即密歇根手部问卷（MHQ）和36项简短健康调查（SF-36），并在3个月时评估恢复工作/休闲情况和依从性水平。
分析了32名参与者（20名男性，平均年龄39.8岁，61条修复肌腱）的数据。受伤后3个月，总主动活动度和Strickland-Glogovac活动度与未受伤手相比，平均活动度分别为83.5%和73.8%，握力为68.4%。与受伤前相比，所有MHQ评分在3个月时均有统计学显著差异（p≤0.012），SF-36的身体角色限制和身体成分总结评分也是如此（p≤0.023）。所有参与者（100.0%）在3个月时均已恢复工作，几乎所有参与者（96.6%）恢复了休闲活动，尽管并非总是恢复到受伤前的水平。受累手指的数量在统计学上显著影响Strickland-Glogovac活动度（p≤0.049）、屈肌功能缺陷（p = 0.042）以及SF-36总结和总分（p≤0.049）。受累肌腱的数量在统计学上显著影响屈肌功能缺陷（p = 0.042）。参与者的依从性在统计学上显著影响MHQ总分（p = 0.028）。
除了临床医生报告的结果外，使用患者报告的结果能更深入地了解患者对屈肌腱损伤后恢复情况的看法。
