Von der Naht zur Funktion: Evaluierung eines frühfunktionellen Rehabilitationsansatzes für Beugesehnennähte im Kontext aktueller Konzepte

Zusammenfassung

Hintergrund

Die wissenschaftlichen Untersuchungen zur Rehabilitation von Beugesehnennähten haben in den letzten Jahren zugenommen. Um die Wirksamkeit und Sicherheit das in unserer Klinik verwendete „Early-Active-Motion“ Nachbehandlungskonzeptes zu evaluieren, wurde eine prospektive Studie entwickelt, die sowohl die funktionellen Ergebnisse als auch die Komplikationsrate über drei Monate untersucht.

Patienten und Methoden

90 Beugesehnennähte in Zone 1–3, mit und ohne Begleitverletzungen, wurden über drei Monate nachuntersucht. Die Beweglichkeit des betroffenen Fingers wurde nach drei, sechs, neun und 12 Wochen gemessen. Compliance war kein Ausschlussgrund.

Ergebnisse

Von insgesamt 90 Beugesehnen konnten 67 über den Zeitraum von drei Monaten nachuntersucht werden. Insgesamt erreichten 43 Finger ein exzellentes oder gutes Ergebnis, 20 einen ausreichenden (fair) und 4 Finger einen schlechten Strickland-Score. Drei Sehnen sind gerissen.

Schlussfolgerung

Das „Early-Active-Motion“ Konzept erreicht ein funktionell gutes Ergebnis bei einem Strickland-Score von 76 Punkten. Es ist von Zone 1 bis Zone 3 auch bei komplexen Beugesehnenverletzungen anwendbar. Eine Verschlechterung in den frühen Phasen scheint ein Indikator für niedrigere Endergebnisse zu sein.

Abstract

Background

Evaluating an early functional rehabilitation approach for flexor tendon repairs in the context of current concepts ABSTRACT Background: In recent years, an increase in scientific research on the post-treatment of flexor tendon repairs has been observed. To evaluate the effectiveness and safety of the “Early-Active-Motion” concept that has been used in our clinic for over 10 years, a prospective study was developed that detailed both functional outcomes and complication rates over a period of 3 months.

Patients and methods

90 flexor tendon repairs in Zones 1–3, with and without accompanying injuries, were examined after three, six, nine and 12 weeks. Compliance was not a reason for exclusion. The collected parameters included the DASH, finger mobility according to the Strickland-Score, and other assessments.

Results

Out of a total of 90 flexor tendons, follow-up was achieved on 67 over a period of three months. Overall, 43 of the tendons achieved an excellent or good outcome. 20 had a fair outcome, and 4 of the digits had a poor Strickland Score. A total of three ruptures were documented.

Conclusion

The “Early-Active-Motion” concept achieves a functionally good outcome with a Strickland-Score of 76 points. It is applicable from Zone 1 to Zone 3, even in complex flexor tendon injuries. Early phase deterioration appears to be an indicator of lower final outcomes.

Schlüsselwörter

Sehne - Rehabilitation - Beugesehnennaht - frühfunktionell - Nachbehandlung

Keywords

flexor tendon repair - early-active - active mobilization

Publikationsverlauf

Eingereicht: 24. Juli 2024

Angenommen: 18. August 2025

Artikel online veröffentlicht:
07. Oktober 2025

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