What is the Kleinert protocol for a flexor tendon injury repair?
In the original Kleinert protocol, the dorsal blocking splint blocked the wrist in 45 degrees of flexion and the MP joints in 10 to 20 degrees. Rubber band traction was directed to the fingernail from the wrist or just proximal to the wrist.
What is the modified Duran protocol?
The exercise program is referred to as the “Modified Duran Exercise Program”. It is important to place equal emphasis on the passive extension & the passive flexion. It is through the effort of passive extension that allows the tendon to glide distal from the repair site.
When is tendon repair the weakest?
2-3 Weeks: the tendon is at its’ weakest point. 4-5 Weeks: the tendon is firm, but weak. 5-6 Weeks: the tendon is becoming stronger.
What is Kleinert protocol?
Objective: Kleinert (active extension, rubber-band passive flexion) and Duran (passive extension, passive flexion) protocols are two basic types of early motion programs for rehabilitation of flexor tendon injuries.
Which splint is used for flexor tendon injury?
7 therapeutic protocols following flexor tendon repair Even so, one constant in all rehabilitation protocols has remained the Dorsal Blocking Orthosis. A versatile splint that limits the amount of active and passive finger extension to prevent possible tendon rupture.
What is a blocking splint?
The Dorsal Blocking Orthosis is a dorsally placed immobilization orthosis designed to protect the sutured/repaired flexor tendons and/or nerves in a tension free position. Other names for this splint include Extension Block Splint, Dorsal shell, and Dorsal Protective splint.
How do you test for FDS?
The FDS to the middle finger is tested by holding the other 3 fingers in full extension, thereby immobilizing the profundis [FDP] (shown in black), and asking the patient to “bend the finger.” Note that the FDP flexes the DIP specifically, but will also flex the PIP indirectly as well.
How do you test Fds for index finger?
Thus the common maneuver for testing the FDS is to hold all other fingers fully extended while allowing only one finger at a time to flex, assuring the proximal interphalangeal (PIP) joint actively flexes but there is no tension from the FDP across the DIP joint.
What is a flexor lag?
(“I-P flexion lag”—I.P.F.L.) Clinical causes include shortening of the muscletendon unit, loss of pulleys with bowstringing, adhesions and hypermobile joints.
How do you stretch FDS?
To give your flexor digitorum superficialis a good stretch, stand an arm’s length from a wall. Place your flattened hand on the wall with your fingers pointing downwards. Gently lean into your palm to feel a stretch. Hold for 15-30 seconds then switch arms.
How is FDS function tested?
To test flexor digitorum superficialis, the patient is asked to flex PIP joint of one of the digits from 2nd to 5th while other remaining three digits held in extension so as to inactivate Flexor Digitorum Profundus.
What vitamins help repair tendons?
Preliminary evidence suggests that various nutrients such as proteins, amino acids (leucine, arginine, glutamine), vitamins C and D, manganese, copper, zinc, and phytochemicals may be useful in improving tendon growth and healing.
What is the FDS tendon?
Flexor digitorum superficialis (FDS) tendons FDS tendons help bend the index, middle, ring, and small fingers at the middle finger joint. They are powered by a common muscle belly shared by all the fingers, which divides into 4 tendons. They travel down the forearm and within the carpal tunnel.