Background: Flexor tendon repair of the hand and the rehabilitation thereof are commonly discussed between hand surgeons and therapists. There are many patients in public hospitals in South Africa who require this surgery. They are regularly sent to the therapists for rehabilitation, using the early passive motion protocol. Although the early active motion protocol has yielded improved results globally, there is limited evidence on the comparison of the outcomes of these 2 protocols in the South African context. This study was implemented to compare the outcomes of these 2 protocols in a large public hospital post flexor tendon repair. Methods: Patients (n = 46) who sustained a zone II-IV flexor tendon injury were recruited for the study and equally distributed between the 2 groups (early active motion and early passive motion). Out of these participants, 11 did not return for the initial assessment at 4 weeks post surgery and were therefore excluded. There were 19 participants in the early active motion group and 16 participants in the early passive motion group. Results were collected and classified at 4, 8, and 12 weeks post surgery. The collection of data commenced in December 2014 and was completed in January 2016. Results: The results of the study included total active motion and tip to crease and tip to table measurements of the injured and uninjured fingers. At 12 weeks post surgery, the average total active motion of the injured fingers was similar between the early active and early passive motion protocols (57.46%, 61.00%, respectively). Tip to crease and tip to table measurements were also similar between the 2 groups. In terms of patient compliance, 52.17% of participants removed their splints in the initial 4-week period, and 56.52% carried out the prescribed exercises correctly. Tendon rupture occurred in 8.57% (n = 3, early active motion = 5.71%, early passive motion = 2.86%) of patients. Conclusion: There has been a global trend toward the use of an early active motion protocol post flexor tendon repair. This study found that there was no difference in outcomes between the 2 groups. Therefore, either protocol could be implemented in South African public hospitals. However, because the early active motion protocol takes less time to implement, this protocol is recommended. A larger study would be necessary to determine a significant comparison between the 2 groups; however, this is challenging due to poor patient compliance.
