Erfahrungen mit dem Short Arc Motion (SAM)-Schema in der Nachbehandlung isolierter Strecksehnenverletzungen der Zonen E und F nach Wilhelm

Abstract

Rehabilitation of extensor tendon injuries in zones E and F (according to Wilhelm) is difficult because of the broad bone-tendon interface favouring adhesions. Therefore RB Evans developed the so called "short arc motion" protocol to improve the results of extensor tendon injuries in zones E and F. This protocol consists of immobilisation of the PIP and DIP joints of the injured finger interrupted by regularly performed limited active motion exercises according to the principle of "minimal active tension". Evans demonstrated superior results using this protocol compared to pure immobilisation. In this study we retrospectively evaluated our results using the "short arc motion" regime in isolated extensor tendon injuries since 2000. 10 patients could be examined with a mean follow-up of 2 years and 5 months after operative treatment of fresh extensor tendon injuries as well as one patient with an old extensor tendon lesion. According to the Strickland-Glogovac formula our patients with fresh extensor tendon lesions had 70.3 % on average which is a good result. Using the Geldmacher score these patients had a mean result of 20.7 points indicating a good result too. With regard to the PIP joint, the mean extension deficit was 8.5 degrees. So our results are good, but not as good as those from Evans. Being aware of the limitations of a retrospective study lacking a control group of patients with traditional aftercare, we will continue to use the SAM protocol in our hospital.