Fleksör Tendon Kesisi Olan Hastalarda Erken Aktif Mobilizasyon ve Modifiye Duran Protokollerinin Etkinliğinin Retrospektif Olarak İncelenmesi

Abstract

Introduction: There is no consensus on which rehabilitation protocol works better after tendon repairs. In addition, there is no study evaluating the tendon status in the early and late stages by USG. The aim of this study is to determine the superiority of the protocols compared to each other by comparing the relationship between the tendon shift amount, tendon diameter (CSA = cross sectional area) and finger functional results of the Belfast and Modified Duran protocols, and also to predict the results of the tendons evaluated by USG at the early stage of healing. Materials and Methods:. 19 of 34 patients (21 fingers) who applied to Hacettepe University Department of Physical Medicine and Rehabilitation for rehabilitation were treated with Belfast protocol and the remaining 15 patients (20 fingers) were treated with Modified Duran protocol. Previously evaluated by USG and the data in our system after the operation 3-5th weeks and 12th week tendon gliding and cross sectional area (CSA) measurements were used in the study. In addition, Buck Gramcko scores of the patients were calculated by taking the range of motion of the finger joints and the distance of the finger pulp to the distal palmar line by flexion. The relationship between USG data and functional results was investigated. Results: Three (% 8.8) of the patients were female and thirty one patients (% 91.2) were male. The average age was found as 30.53 ± 13.53 years. When Belfast and Modified Duran protocols were compared according to Buck Gramcko score, there was no significant difference between the two protocols (p>0.05). There was no significant relationship between patients' CSA and tendon shift. There was no significant correlation between the first tendon shift and 12th week Buck Gramcko score (p>0.05). Conclusion: In our study, we evaluated the physical therapy process performed after repair of the hand finger flexor tendons with USG. To date in literature, we have not encountered any other study evaluating the effectiveness of rehabilitation programs applied after tendon repair with USG. Although there is no significant difference between the two protocols in our study, it is predicted that the early active mobilization process will be superior in terms of tendon shift and functional results compared to passive mobilization, although further studies in which the evaluation of the morphology and shift of the tendons on functional results are required in the rehabilitation process.