Treatment of a zone III extensor tendon injury using a single relative motion with dorsal hood orthosis and a modified short arc motion protocold-A case report

Study Design: Case report. Introduction: Zone III extensor tendon injuries are typically treated with early mobilization or by a period of immobilization followed by gradual motion. In both scenarios, the use of multiple orthoses is required. Purpose of the study: This case report examines the effective use of a single, modified relative motion orthosis throughout the protected rehabilitation phase after a zone III extensor tendon repair. Methods: A patient with extensor tendon zone III laceration to his index finger (10th revision of the International Statistical Classification of Diseases and Related Health Problems s66.328) was treated using a single, relative motion with dorsal hood orthosis. The exercise protocol followed a modified immediate short arc motion program. Results: Following laceration and complete rupture of the central slip, the patient regained full range of motion, strength, and function. Discussion: It is becoming more common to use a relative motion flexion (RMF) orthosis to correct or improve extensor lag due to boutonniere deformity or stiffness after finger fractures. There is very little literature to support the use of the RMF orthosis after zone III extensor tendon repair. To produce a single orthosis that is useful through the entire protected phase of rehabilitation, the RMF orthosis is easily modified by addding a dorsal hood to create the relative motion dorsal hood orthosis (RMDH). Conclusion: Our case report shows the successful treatment of a zone III extensor tendon repair using a single relative motion with dorsal hood orthosis and early active motion throughout the entire protected phase of rehabilitation. (C) 2019 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.