Relative Motion Extension Orthosis Versus Classic Immobilization in Extensor Tendon Repairs (Zones IV-VI of the Hand): A Randomized Controlled Trial

Abstract

Background:

Traditional treatment for extensor tendon injuries typically involves tenorrhaphy followed by a 4- to 6-week period of immobilization in a plaster orthosis. This study compares the efficacy of relative motion extension (RME) orthoses versus classic immobilization (CI) in promoting recovery after such injuries.

Methods:

We conducted a randomized, controlled, blind clinical trial approved by the Galicia ethics committee. Participants were individuals with single tendon injuries in the long fingers. They were randomly assigned to either the RME or the CI treatment group. Outcome measures, including range of motion, grip strength, pain (Visual Analog Scale), comfort level, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores, were assessed at 4 and 6 weeks post-treatment. The RME group used a daytime RME orthosis and a static nocturnal orthosis.

Results:

The study included 30 participants, 15 in each group. There were no significant differences in demographics or baseline characteristics between groups. Significant improvements were seen in the RME group in terms of grip strength, metacarpophalangeal and interphalangeal joint flexion, and QuickDASH scores (P < .05). Furthermore, 87% of the RME group reported high comfort levels with their orthoses, compared with 43% in the CI group.

Conclusions:

Our findings suggest that RME orthoses are more effective than CI in improving initial functional outcomes post-extensor tendon tenorrhaphy. Patients in the RME group experienced better grip strength, increased flexion, reduced pain, and greater overall comfort during recovery. These advantages point to RME orthoses as a preferable method for managing extensor tendon injuries.

This clinical trial was registered with ClinicalTrials.gov, registration number NCT06950268, URL: https://clinicaltrials.gov/study/NCT06950268.