The authors prospectively reviewed the short-term results of surgically repaired open central slip (zone 3) injuries which were treated with 3 weeks of proximal interphalangeal (PIP) joint static extension splinting followed by 3 weeks of controlled mobilization with a dynamic PIP extension splint. Thirty-one fingers in 27 patients were clinically assessed 8 weeks postoperatively, 2 weeks after discontinuing splint treatment. Mean PIP flexion measured 94 degrees (range, 70 ? 110 degrees), and mean distal interphalangeal (DIP) joint flexion measured 57 degrees (range, 30 ? 81 degrees). Extension deficits of the PIP joint were noted in only 5 fingers (mean 6 degrees; range, 3 ? 15 degrees).
The results of this study show that a combination of static extension (3 weeks) and dynamic (3 weeks) PIP extension splinting is an effective rehabilitation regime for surgically repaired open central slip injuries. Other authors have stated that static PIP extension splinting for longer periods of time (e.g., 6 weeks) may lead to poor extensor tendon excursion, extension deficits, joint stiffness, and loss of finger flexion (Evans and Thompson, J Hand Therapy 5:187-201, 1992). Both the metacarpophalangeal and DIP joints of the injured digit and all joints in the adjacent digits should be mobilized during the periods of static and dynamic PIP splinting.
Journal of Hand Surg