7. Clinical observation of hand function recovery using various methods of autotendon reconstruction and rehabilitation

Abstract

Background. The purpose of the study was to compare objective (range of motion, hand strength) and subjective (Arm, Shoulder, and Hand Disability Questionnaire, Visual Analogue Pain Rating Scale) indicators of the effectiveness of one-stage and two-stage autograft reconstruction combined with Kleinert and SMART rehabilitation methods in hand injuries of different ages.

Methods. The study included 200 patients (2021-2024) who underwent surgical treatment of flexor tendon injuries of the fingers at the Syzganov National Scientific Center of Surgery. Patients were divided into the main group (n = 80), which received two-stage reconstruction and rehabilitation according to the SMART method, and the control group (n = 120), which received one-stage reconstruction and rehabilitation according to the Kleinert method. Efficacy was assessed by range of motion, hand grip strength, Rozov's scale, Disabilities of the Arm, Shoulder, and Hand questionnaire, and visual analog scale pain scores.

Results. By the 6th month of rehabilitation, the SMART method demonstrated better results in functional movement assessment (65% vs. 60%, p = 0.05), pain reduction (4.0 vs. 3.2, p < 0.05), and shorter return-to-work time (10 vs. 12 weeks, p < 0.05). However, the Kleinert method proved effective in patients with subacute injuries.

Conclusion. The Stimulated Motion And Recovery Therapy hand rehabilitation method combined with two-stage reconstruction is effective in the long-term consequences of trauma, while the Kleinert method is preferable in subacute injuries. Restoration of hand function requires a multidisciplinary approach.