The Manchester short splint: A change to splinting practice in the rehabilitation of zone II flexor tendon repairs

Abstract

Introduction

The results of patients with primary zone II flexor tendon repairs rehabilitated using a traditional forearm-based splint were audited and compared with those who were managed in the Manchester short splint.

Method

The short splint was fabricated to permit maximal wrist flexion and up to 45° of wrist extension with a block to 30° of metacarpophalangeal joint extension. A rehabilitation regimen consisting of early combined passive flexion exercises and active motion was employed. In 2011, 62 patients (76 digits) with a mean age of 34 years (range 14–58) were rehabilitated using the forearm-based splint (group A). In 2012, 40 patients (45 digits) with a mean age of 31 years (range 15–71) were rehabilitated using the Manchester short splint (group B).

Results

Group B had significantly less flexion contracture at their proximal interphalangeal joints than group A at 6 weeks (median 15° versus 28°; p = 0.003) and 12 weeks (median 6° versus 18°; p = 0.024) postoperatively. At the final review, group B had a significantly greater arc of flexion at their distal interphalangeal joints (median 59° versus 30°; p < 0.001) and a greater proportion of patients with excellent/good Strickland’s grades. There were three (3.9%) ruptures in group A and two (4.4%) ruptures in group B (p > 0.999).

Conclusion

The use of a shorter splint would appear to enhance the outcomes whilst preserving repair integrity.