Relative active motion programs following extensor tendon repair: A pilot study using a prospective cohort and evaluating outcomes following orthotic interventions.

STUDY DESIGN: Prospective cohort. INTRODUCTION: The Immediate Controlled Active Motion program, used to manage extensor tendon repairs in the hand, immobilizes the wrist in an orthosis with the affected finger(s) placed in a separate yoke orthosis allowing controlled flexion. PURPOSE: To compare our outcomes using similar programs in patients with simple extensor tendon lacerations to those previously reported. To compare our 4-week orthotic intervention to our 6-week orthotic intervention. METHODS: 18 subjects received a 4-week orthotic intervention, 45 subjects received a 6-week orthotic intervention. Range of motion was measured 4, 6 and 8 weeks post-repair, grip strength at 6 and 8 weeks, and patient-rated outcomes at baseline, 6 and 12 weeks post-repair. RESULTS: Significant improvements in all outcomes were seen over time (p < 0.0001), with no significant differences between programs. CONCLUSION: Outcomes were comparable with those previously published and similar between the 4-week and 6-week orthotic interventions. LEVEL OF EVIDENCE: III.

Reliability testing of a new scar assessment tool, Matching Assessment of Scars and Photographs (MAPS).

A new scar-assessment tool, the Matching Assessment of Scars and Photographs (MAPS), which uses a set of reference photographs, a numeric scale, and location technique, was tested for its reliability in two stages. First, using five adults, three raters assessed 32 burns scars twice within 3 days. Subsequently, reliability was tested during a 6-month time frame, emphasizing the process of localizing test areas as scars changed and raters forgot the previous assessment. Three raters, from a pool of five, each made three assessments on 29 scars in seven subjects, on average 8 weeks apart. Inter-rater reliability was tested, using Kendall's Tau C and intraclass correlations, respectively, for stages 1 and 2. Agreement was good for border height (0.63-0.70 and 0.78), moderate to good for thickness (0.60-0.74 and 0.81), and good for color (0.55-0.71 and 0.79), whereas for surface it was fair (0.25-0.38 and 0.40). The localization technique was reliable (accuracy within 3 mm) in 93% to 96% of recordings. The MAPS tool is considered ready for clinical use.