Flexor and extensor tendon rehabilitation after repair - Why we changed and how we changed our treatment protocols.
Course participants will know the evidence that supports early active tendon motion post repair and will be able to implement the guidelines as presented for both digital flexors and extensors.
On Flexor tendons:
New surgical techniques, new concepts and research on tendon biomechanics and healing of a flexor tendon, but also new insights into motor cortex changes during the postoperative phase have resulted in the use of improved active protocols after flexor tendon repair.
• The relevant research that changed our way of treating a flexor tendon repair will be presented. Topics that will be addressed are work of flexion and how edema, pulleys, positioning of the finger and wrist can increase friction on the tendon (WOF); and why the FDP needs our special attention.
• How to actually execute an early active treatment in your practice, including the different options that are available for personalizing the treatment to each individual patient, will be discussed. Unfortunately there is no “one” protocol that can be presented as there is no research that has singled out any specific protocol as being most effective. Clinical reasoning is still the cornerstone of the optimal treatment process. The “when and where” of making the right choice or adapting a treatment for each individual patient will be illustrated .
•To improve outcomes there are many tricks and tips. To improve outcomes motorcortex changes that can occur after flexor tendon injury will also be discussed as the altered moving pattern (during exercising) can result in less tendon glide. Tips will be given to ensure optimal tendon glide through exercises that take these changes into account.
• And lastly the role of purposeful exercises in active tendon protocols is discussed as these types of exercises resulted in more exercise repetitions and improved hand function compared to rote exercises.
Recommendations will be given during this talk on how to choose the best splint position, how to move the tendon you actually want to move and which exercises might give improved results.
On extensor tendons :
Starting back in the late 70’s and early 80’s there have been two specific early active protocols that have been used succesfully when treating postoperative/postinjury care with extensor tendon injuries in zones 3-7. Only the last decade have these two protocols become widespread and popular because of their superior results and the lack of complications. As for the mallet finger (extensor tendon injury zones 1 -2), these have always been a challenge for therapists and surgeons alike. Results seem to never give consistently good or excellent outcomes.
•During the lectures on extensor tendons both the relative motion and the short arc motion protocols will be presented for zones 3-7. And for the mallet finger I will present my personal take on the treatment of these injuries with the literature to support my views of course.
• The latest research for all the above will be presented and a practical guide to use the different treatment approaches will be presented with a video on how to fabricate the RM flexion and extension splints and how to apply plaster of paris casting techniques for the mallet finger.
Gwendolyn van Strien MSc. CHT, RPT
Gwendolyn van Strien ist eine erfahrene Hand- und Physiotherapeutin aus den Niederlanden, die bis 2018 in eigener Praxis selbständig tätig war und eine beratende Funktion im LangeLand Spital innehatte. Als Dozentin im Bereich der Handtherapie ist sie international bekannt und verfügt über eine zahlreiche Vortrags- und Referententätigkeit. Sie hat zur Rehabilitation nach Sehnenverletzungen Artikel und Buchkapitel (Rehabilitation of the Hand Upper Extremity) publiziert. Bis Februar 2018 gehörte sie auch dem Redaktionsteam von Hand Therapy an.
€95,-- (Membre: €70,--)
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