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Friction of the gliding surface : implications for tendon surgery and rehabilitation
AMADIO PC
J HAND THER , 2005, vol. 18, n° 2, p. 112-119 Doc n°: 120968 Localisation : Documentation IRR Descripteurs : DD861 - TRAITEMENT CHIRURGICAL - MAIN-DOIGTS Finger flexor tendon rehabilitation has come a long way, but further advances are possible. Ideally, a healing tendon should move, but under the minimum load necessary to achieve motion. It is possible to design suture repairs that minimize the friction between tendon and sheath while simultaneously maintaining adequate strength to provide a wide margin of safety during therapy. A looped, four-strand modified Kessler repair is a good example of this type of high-strength, low-friction repair. At the same time, rehabilitation methods can also be optimized. A new modified synergistic motion protocol is described in which wrist flexion and finger extension is alternated with wrist and metacarpophalangeal joint extension and finger interphalangeal joint flexion. Based on evidence from basic science studies, the authors hypothesize that this new protocol will deliver more effective proximal tension on the tendon repair than either passive flexion/active extension or synergistic protocols, and may be useful in patients who are not ready for, Langue : ANGLAIS |
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