In 2008, Megerle, et. al., conducted prospective randomized trial, which aimed to assess the outcomes and complications associated with two distinct postoperative treatment protocols after extensor indicis tendon transfer. The study compared the efficacy of dynamic motion, involving passive extension using a rubber band system, with early active motion, which initiated active thumb extension. The evaluation included active range of motion in the interphalangeal (IP) and metacarpophalangeal (MP) joints, as well as grip and pinch strength. Additionally, complications during the first year following the procedure were recorded.

Twenty-one patients, comprising 10 females and 11 males, were randomly assigned to either the dynamic or active treatment group. Patients’ progress was assessed at regular intervals during the third, fourth, sixth, and eighth postoperative weeks. Statistical analysis was performed using chi-square and Mann-Whitney U-tests.

By the eighth postoperative week, patients in the dynamic treatment group exhibited an average IP joint range of motion of 69 degrees (ranging from 45 to 110 degrees), while those in the active treatment group showed an average range of 58 degrees (ranging from 40 to 75 degrees). Notably, after three weeks, the dynamic treatment group demonstrated significantly greater ranges of motion (p=0.03). However, no significant differences between the two groups were observed during the subsequent treatment period. After eight weeks, the average grip and pinch strength were 66% and 73% of the contralateral side, respectively, in the dynamic group, and 63% and 71% in the active group.

Based on the outcomes observed in this study, both the dynamic and active treatment protocols exhibited comparable clinical results after eight weeks of rehabilitation. The use of early active motion did not result in a higher rate of complications but did not expedite the rehabilitation process either. Although the sample size was limited, these findings provide valuable insights into the postoperative management of patients who have undergone extensor indicis tendon transfer. Further research with larger patient cohorts would be beneficial to validate these results and guide future treatment decisions.

Reference: Megerle, K., Przybilski, M., Sauerbier, M., Germann, G., & Giessler, G. A. (2008). Early active motion after transfer of the extensor indicis tendon–a randomised prospective trial. Handchirurgie, Mikrochirurgie, Plastische Chirurgie: Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie: Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse: Organ der V…, 40(3), 156-159.