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Semin Plast Surg 2015; 29(01): 073-080
DOI: 10.1055/s-0035-1544172
DOI: 10.1055/s-0035-1544172
Rehabilitation of the Upper Extremity Following Nerve and Tendon Reconstruction: When and How
Further Information
Publication History
Publication Date:
04 February 2015 (online)
![](https://www.thieme-connect.de/media/sps/201501/lookinside/thumbnails/10.1055-s-0035-1544172-1.jpg)
Abstract
Following upper extremity nerve and tendon reconstruction, rehabilitation is necessary to achieve optimal function and outcome. In this review, the authors present current evidence and literature regarding the strategies and techniques of rehabilitation following peripheral nerve and tendon reconstruction.
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References
- 1 Novak CB, von der Heyde RL. Hand therapy. In: Neligan PC, Chang J, , eds. Plastic Surgery. London: Elsevier Saunders; 2013: 855-869
- 2 Clare TD, de Haviland Mee S, Belcher HJCR. Rehabilitation of digital nerve repair: is splinting necessary?. J Hand Surg [Br] 2004; 29 (6) 552-556
- 3 Novak CB, Anastakis DJ, Beaton DE, Katz J. Patient reported outcome following peripheral nerve injury. J Hand Surg Am 2009; 34 (2) 281-287
- 4 Novak CB, Katz J. Neuropathic pain in patients with upper-extremity nerve injury. Physiother Can 2010; 62 (3) 190-201
- 5 Gordon T, Sulaiman OAR, Ladak A. Chapter 24: Electrical stimulation for improving nerve regeneration: where do we stand?. Int Rev Neurobiol 2009; 87: 433-444
- 6 Fu SY, Gordon T. Contributing factors to poor functional recovery after delayed nerve repair: prolonged denervation. J Neurosci 1995; 15 (5 Pt 2): 3886-3895
- 7 Williams HB. The value of continuous electrical muscle stimulation using a completely implantable system in the preservation of muscle function following motor nerve injury and repair: an experimental study. Microsurgery 1996; 17 (11) 589-596
- 8 Eberstein A, Eberstein S. Electrical stimulation of denervated muscle: is it worthwhile?. Med Sci Sports Exerc 1996; 28 (12) 1463-1469
- 9 Michlovitz SL. Is there a role for ultrasound and electrical stimulation following injury to tendon and nerve?. J Hand Ther 2005; 18 (2) 292-296
- 10 Gordon T, Brushart TM, Amirjani N, Chan KM. The potential of electrical stimulation to promote functional recovery after peripheral nerve injury—comparisons between rats and humans. Acta Neurochir Suppl (Wien) 2007; 100: 3-11
- 11 Dellon AL, Curtis RM, Edgerton MT. Reeducation of sensation in the hand after nerve injury and repair. Plast Reconstr Surg 1974; 53 (3) 297-305
- 12 Dellon AL. Somatosensory Testing and Rehabilitation. Baltimore, MD: Institute for Peripheral Nerve; 2000
- 13 Imai H, Tajima T, Natsumi Y. Successful reeducation of functional sensibility after median nerve repair at the wrist. J Hand Surg Am 1991; 16 (1) 60-65
- 14 Novak CB, Kelly L, Mackinnon SE. Sensory recovery after median nerve grafting. J Hand Surg Am 1992; 17 (1) 59-68
- 15 Spicher CJ, Mathis F, Degrange B, Freund P, Rouiller EM. Static mechanical allodynia (SMA) is a paradoxical painful hypo-aesthesia: observations derived from neuropathic pain patients treated with somatosensory rehabilitation. Somatosens Mot Res 2008; 25 (1) 77-92
- 16 Rosen B, Lundborg G. Sensory re-education following nerve repair. In: Slutsky DJ, , ed. Upper Extremity Nerve Repair—Tips and Techniques: A Master Skills Publication. Rosemont, IL: American Society for Surgery of the Hand; 2008: 159-178
- 17 McCabe C. Mirror visual feedback therapy. A practical approach. J Hand Ther 2011; 24 (2) 170-178 , quiz 179
- 18 Moucha R, Kilgard MP. Cortical plasticity and rehabilitation. Prog Brain Res 2006; 157: 111-122
- 19 Rosén B, Lundborg G. Training with a mirror in rehabilitation of the hand. Scand J Plast Reconstr Surg Hand Surg 2005; 39 (2) 104-108
- 20 Oud T, Beelen A, Eijffinger E, Nollet F. Sensory re-education after nerve injury of the upper limb: a systematic review. Clin Rehabil 2007; 21 (6) 483-494
- 21 Melzack R, Wall PD. Pain mechanisms: a new theory. Science 1965; 150 (3699) 971-979
- 22 Ramachandran VS, Altschuler EL. The use of visual feedback, in particular mirror visual feedback, in restoring brain function. Brain 2009; 132 (Pt 7) 1693-1710
- 23 Moseley GL, Wiech K. The effect of tactile discrimination training is enhanced when patients watch the reflected image of their unaffected limb during training. Pain 2009; 144 (3) 314-319
- 24 Anastakis DJ, Chen R, Davis KD, Mikulis D. Cortical plasticity following upper extremity injury and reconstruction. Clin Plast Surg 2005; 32 (4) 617-634 , viii
- 25 Malessy MJ, Bakker D, Dekker AJ, Van Duk JG, Thomeer RT. Functional magnetic resonance imaging and control over the biceps muscle after intercostal-musculocutaneous nerve transfer. J Neurosurg 2003; 98 (2) 261-268
- 26 Duff SV. Impact of peripheral nerve injury on sensorimotor control. J Hand Ther 2005; 18 (2) 277-291
- 27 Chen R, Anastakis DJ, Haywood CT, Mikulis DJ, Manktelow RT. Plasticity of the human motor system following muscle reconstruction: a magnetic stimulation and functional magnetic resonance imaging study. Clin Neurophysiol 2003; 114 (12) 2434-2446
- 28 Merzenich MM, Jenkins WM. Reorganization of cortical representations of the hand following alterations of skin inputs induced by nerve injury, skin island transfers, and experience. J Hand Ther 1993; 6 (2) 89-104
- 29 Taylor KS, Anastakis DJ, Davis KD. Cutting your nerve changes your brain. Brain 2009; 132 (Pt 11) 3122-3133
- 30 Novak CB. Rehabilitation following motor nerve transfers. Hand Clin 2008; 24 (4) 417-423
- 31 Novak CB. Rehabilitation following nerve transfer. In: Slutsky DJ, , ed. Upper Extremity Nerve Repair - Tips and Techniques: A Master Skills Publication. Rosemont, IL: American Society for Surgery of the Hand; 2008: 261-266
- 32 Mackinnon SE, Novak CB, Myckatyn TM, Tung TH. Results of reinnervation of the biceps and brachialis muscles with a double fascicular transfer for elbow flexion. J Hand Surg Am 2005; 30 (5) 978-985
- 33 Tung TH, Novak CB, Mackinnon SE. Nerve transfers to the biceps and brachialis branches to improve elbow flexion strength after brachial plexus injuries. J Neurosurg 2003; 98 (2) 313-318
- 34 Merrell GA, Barrie KA, Katz DL, Wolfe SW. Results of nerve transfer techniques for restoration of shoulder and elbow function in the context of a meta-analysis of the English literature. J Hand Surg Am 2001; 26 (2) 303-314
- 35 Oberlin C, Béal D, Leechavengvongs S, Salon A, Dauge MC, Sarcy JJ. Nerve transfer to biceps muscle using a part of ulnar nerve for C5-C6 avulsion of the brachial plexus: anatomical study and report of four cases. J Hand Surg Am 1994; 19 (2) 232-237
- 36 Novak CB, Mackinnon SE. Distal anterior interosseous nerve transfer to the deep motor branch of the ulnar nerve for reconstruction of high ulnar nerve injuries. J Reconstr Microsurg 2002; 18 (6) 459-464
- 37 Kendall FP, McCreary EK, Provance PG. Muscles: Testing and Function. Baltimore, MD: Williams & Wilkins; 1993
- 38 Sahrmann SA. Diagnosis and Treatment of Movement Impairment Syndromes. St. Louis, MO: Mosby; 2002
- 39 Starr HM, Snoddy M, Hammond KE, Seiler III JG. Flexor tendon repair rehabilitation protocols: a systematic review. J Hand Surg Am 2013; 38 (9) 1712-7.e1 , 14
- 40 Groth GN. Pyramid of progressive force exercises to the injured flexor tendon. J Hand Ther 2004; 17 (1) 31-42
- 41 Amadio PC. Friction of the gliding surface. Implications for tendon surgery and rehabilitation. J Hand Ther 2005; 18 (2) 112-119
- 42 Tanaka T, Amadio PC, Zhao C, Zobitz ME, An KN. Gliding resistance versus work of flexion—two methods to assess flexor tendon repair. J Orthop Res 2003; 21 (5) 813-818
- 43 Zhao C, Amadio PC, Paillard P , et al. Digital resistance and tendon strength during the first week after flexor digitorum profundus tendon repair in a canine model in vivo. J Bone Joint Surg Am 2004; 86-A (2) 320-327
- 44 Zhao C, Amadio PC, Tanaka T , et al. Short-term assessment of optimal timing for postoperative rehabilitation after flexor digitorum profundus tendon repair in a canine model. J Hand Ther 2005; 18 (3) 322-329 , quiz 329
- 45 Cao Y, Tang JB. Investigation of resistance of digital subcutaneous edema to gliding of the flexor tendon: an in vitro study. J Hand Surg Am 2005; 30 (6) 1248-1254
- 46 Cao Y, Chen CH, Wu YF, Xu XF, Xie RG, Tang JB. Digital oedema, adhesion formation and resistance to digital motion after primary flexor tendon repair. J Hand Surg Eur Vol 2008; 33 (6) 745-752
- 47 Cao Y, Tang JB. Resistance to motion of flexor tendons and digital edema: an in vivo study in a chicken model. J Hand Surg Am 2006; 31 (10) 1645-1651
- 48 Buonocore S, Sawh-Martinez R, Emerson JW, Mohan P, Dymarczyk M, Thomson JG. The effects of edema and self-adherent wrap on the work of flexion in a cadaveric hand. J Hand Surg Am 2012; 37 (7) 1349-1355
- 49 Manske PR. History of flexor tendon repair. Hand Clin 2005; 21 (2) 123-127
- 50 Kleinert HE, Kutz JE, Cohen MJ. Primary repair of zone 2 flexor tendon lacerations. Paper presented at: American Academy of Orthopaedic Surgeons: Symposium on Tendon Surgery in the Hand 1975;91–104
- 51 Duran RE, Houser RG. Controlled passive motion following flexor tendon repair in zones two and three. In: Hunter J, Schneider L, , eds. American Academy of Orthopaedic Surgeons: Symposium on Tendon Surgery in the Hand. St. Louis. MO: CV Mosby; 1975: 105-114
- 52 Groth GN. Current practice patterns of flexor tendon rehabilitation. J Hand Ther 2005; 18 (2) 169-174
- 53 Cooney WP, Lin GT, An KN. Improved tendon excursion following flexor tendon repair. J Hand Ther 1989; 2: 102-106
- 54 Evans RB, Thompson DE. The application of force to the healing tendon. J Hand Ther 1993; 6 (4) 266-284
- 55 Lieber RL, Amiel D, Kaufman KR, Whitney J, Gelberman RH. Relationship between joint motion and flexor tendon force in the canine forelimb. J Hand Surg Am 1996; 21 (6) 957-962
- 56 Lieber RL, Silva MJ, Amiel D, Gelberman RH. Wrist and digital joint motion produce unique flexor tendon force and excursion in the canine forelimb. J Biomech 1999; 32 (2) 175-181
- 57 Savage R. The influence of wrist position on the minimum force required for active movement of the interphalangeal joints. J Hand Surg [Br] 1988; 13 (3) 262-268
- 58 Zhao C, Amadio PC, Zobitz ME, Momose T, Couvreur P, An KN. Effect of synergistic motion on flexor digitorum profundus tendon excursion. Clin Orthop Relat Res 2002; (396) 223-230
- 59 Strickland JW, Cannon NM. Flexor tendon repair - Indiana method. Indiana Hand Center Newsletter 1993; 1: 1-18
- 60 Coats II RW, Echevarría-Oré JC, Mass DP. Acute flexor tendon repairs in zone II. Hand Clin 2005; 21 (2) 173-179
- 61 Lalonde D. How the wide awake approach is changing hand surgery and hand therapy: inaugural AAHS sponsored lecture at the ASHT meeting, San Diego, 2012. J Hand Ther 2013; 26 (2) 175-178
- 62 Sandow MJ, McMahon M. Active mobilisation following single cross grasp four-strand flexor tenorrhaphy (Adelaide repair). J Hand Surg Eur Vol 2011; 36 (6) 467-475
- 63 Clancy SP, Mass DP. Current flexor and extensor tendon motion regimens: a summary. Hand Clin 2013; 29 (2) 295-309
- 64 Peck FH, Roe AE, Ng CY, Duf C, McGrouther DA, Lees VC. The Manchester short splint: a change to splinting practice in the rehabilitation of zone II flexor tendon repairs. Hand Ther 2014; 19: 47-53
- 65 Boyer MI, Gelberman RH, Burns ME, Dinopoulos H, Hofem R, Silva MJ. Intrasynovial flexor tendon repair. An experimental study comparing low and high levels of in vivo force during rehabilitation in canines. J Bone Joint Surg Am 2001; 83-A (6) 891-899
- 66 Goldfarb CA, Harwood F, Silva MJ, Gelberman RH, Amiel D, Boyer MI. The effect of variations in applied rehabilitation force on collagen concentration and maturation at the intrasynovial flexor tendon repair site. J Hand Surg Am 2001; 26 (5) 841-846
- 67 Silva MJ, Brodt MD, Boyer MI , et al. Effects of increased in vivo excursion on digital range of motion and tendon strength following flexor tendon repair. J Orthop Res 1999; 17 (5) 777-783
- 68 Greenwald D, Shumway S, Allen C, Mass D. Dynamic analysis of profundus tendon function. J Hand Surg Am 1994; 19 (4) 626-635
- 69 Schuind F, Garcia-Elias M, Cooney III WP, An KN. Flexor tendon forces: in vivo measurements. J Hand Surg Am 1992; 17 (2) 291-298
- 70 Urbaniak JR, Cahill JD, Mortenson RA. Tendon suturing methods: Analysis of tensile strengths. In: Hunter J, Schneider L, , eds. American Academy of Orthopaedic Surgeons: Symposium on Tendon Surgery in the Hand. St. Louis, MO: CV Mosby; 1975: 70-80
- 71 Wehbé MA, Hunter JM. Flexor tendon gliding in the hand. Part II. Differential gliding. J Hand Surg Am 1985; 10 (4) 575-579
- 72 Small JO, Brennen MD, Colville J. Early active mobilisation following flexor tendon repair in zone 2. J Hand Surg [Br] 1989; 14 (4) 383-391
- 73 Tang JB. Indications, methods, postoperative motion and outcome evaluation of primary flexor tendon repairs in Zone 2. J Hand Surg Eur Vol 2007; 32 (2) 118-129
- 74 Farzad M, Layeghi F, Asgari A, Ring DC, Karimlou M, Hosseini SA. A prospective randomized controlled trial of controlled passive mobilization vs. Place and active hold exercises after zone 2 flexor tendon repair. Hand Surg 2014; 19 (1) 53-59
- 75 Frueh FS, Kunz VS, Gravestock IJ , et al. Primary flexor tendon repair in zones 1 and 2: early passive mobilization versus controlled active motion. J Hand Surg Am 2014; 39 (7) 1344-1350
- 76 Trumble TE, Vedder NB, Seiler III JG, Hanel DP, Diao E, Pettrone S. Zone-II flexor tendon repair: a randomized prospective trial of active place-and-hold therapy compared with passive motion therapy. J Bone Joint Surg Am 2010; 92 (6) 1381-1389
- 77 Yen CH, Chan WL, Wong JWC, Mak KH. Clinical results of early active mobilisation after flexor tendon repair. Hand Surg 2008; 13 (1) 45-50
- 78 Strickland JW, Glogovac SV. Digital function following flexor tendon repair in Zone II: A comparison of immobilization and controlled passive motion techniques. J Hand Surg Am 1980; 5 (6) 537-543