Newly developed dynamic splint vs. dynamic outrigger splint for postoperative treatment of extensor tendon rupture in patients with rheumatoid wrists - a preliminary study
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Keywords

dynamic splint
tendon rupture
rheumatoid arthritis
wrist

How to Cite

[1]
Yano, K., Egi, T., Yoneda, M., Tokui, A., Ikeda, M., Kaneshiro, Y. and Kazuki, K. 2019. Newly developed dynamic splint vs. dynamic outrigger splint for postoperative treatment of extensor tendon rupture in patients with rheumatoid wrists - a preliminary study. Revmatologiia (Bulgaria). 27, 1 (Apr. 2019), 24-29. DOI:https://doi.org/10.35465/00003.

Abstract

Aim and object of the study: Extensor tendon rupture in patients with rheumatoid wrists causes dysfunction of the hand and necessitates tendon reconstruction and surgical treatment of the wrist joint. Dynamic outrigger splints using rubber bands have been used for early postoperative mobilization of the fingers. However, these splints are bulky and cause discomfort. We developed a new dynamic splint, which is compact and uses torsion springs instead of the rubber bands used in conventional outrigger splints. The splint extends the metacarpophalangeal joints using a volar finger bar. The objective of this study was to compare the clinical outcomes and subjective assessments between patients treated with the two types of splint. Methodology: Fourteen wrists (14 patients) were included. Clinical outcomes (range of active motion of the metacarpophalangeal joint) and subjective assessments were investigated in patients treated with either an outrigger splint or our new dynamic splint. Results: There were no differences in clinical outcomes between patients treated with the two kinds of splint. The new splint performed better in terms of the subjective assessment of changing clothes and bulkiness.  Conclusions: The new splint yielded equivalent clinical outcomes and better subjective assessments compared to conventional outrigger splints due to its reduced size.

https://doi.org/10.35465/00003
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References

  1. Guo Q, Wang Y, Xu D, Nossent J, Pavlos NJ, Xu J. Rheumatoid arthritis: pathological mechanisms and modern pharmacologic therapies. Bone Res, 2018, 6, 15.
  2. Abe A, Ishikawa H, Murasawa A, Nakazono K. Extensor tendon rupture and three-dimensional computed tomography imaging of the rheumatoid wrist. Skeletal Radio,. 2010, 39(4), 325-331.
  3. Chu PJ, Lee HM, Hou YT, Hung ST, Chen JK, Shih JT. Extensor-tendons reconstruction using autogenous palmaris longus tendon grafting for rheumatoid arthritis patients. J Orthop Surg Res, 2008, 3, 16.
  4. Nakamura S, Katsuki M. Tendon grafting for multiple extensor tendon ruptures of fingers in rheumatoid hands. J Hand Surg Br, 2002, 27(4), 326-328.
  5. Moore JR, Weiland AJ, Valdata L. Independent index extension after extensor indicis proprius transfer. J Hand Surg Am, 1987, 12(2), 232-236.
  6. Williamson SC, Feldon P. Extensor tendon ruptures in rheumatoid arthritis. Hand Clin, 1995, 11(3), 449-459.
  7. Germann G, Wagner H, Blome-Eberwein S, Karle B, Wittemann M. Early dynamic motion versus postoperative immobilization in patients with extensor indicis proprius transfer to restore thumb extension: a prospective randomized study. J Hand Surg Am, 2001, 26(6), 1111-1115.
  8. Chow JA, Dovelle S, Thomes LJ, Ho PK, Saldana J. A comparison of results of extensor tendon repair followed by early controlled mobilisation versus static immobilisation. J Hand Surg Br, 1989, 14(1), 18-20.
  9. Evans RB. Immediate active short arc motion following extensor tendon repair. Hand Clin, 1995, 11(3), 483-512.
  10. Taleisnik J. The Sauve-Kapandji procedure. Clin Orthop Relat Res, 1992, 275, 110-123.
  11. Nolan WB, 3rd, Eaton RG. A Darrach procedure for distal ulnar pathology derangements. Clin Orthop Relat Res, 1992, 275, 85-89.
  12. Geldmacher J, Plank M, Treuheit KD. [Significance of the preoperative status in the evaluation of results of the reconstruction of extensor tendons]. Handchir Mikrochir Plast Chir, 1986, 18(1), 23-29.
  13. Sakuma Y, Ochi K, Iwamoto T, Saito A, Yano K, Naito Y, et al. Number of ruptured tendons and surgical delay as prognostic factors for the surgical repair of extensor tendon ruptures in the rheumatoid wrist. J Rheumatol, 2014, 41(2), 265-269.
  14. Larsen A, Dale K, Eek M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn (Stockh), 1977, 18(4), 481-491.
  15. Gelberman RH, Botte MJ, Spiegelman JJ, Akeson WH. The excursion and deformation of repaired flexor tendons treated with protected early motion. J Hand Surg Am, 1986, 11(1), 106-110.
  16. Evans RB, Burkhalter WE. A study of the dynamic anatomy of extensor tendons and implications for treatment. J Hand Surg Am, 1986, 11(5), 774-779.
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