The effects of edema self adhesive wrap on the work of flexion in a cadaveric hand
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The Effects of Edema & Self Adhesive Wrap on the Work of Flexion in a Cadaveric Hand. Samuel D Buonocore MD. Purpose:. To determine if the application of self adhesive wraps increase the work of flexion when hand therapy is initiated in edematous fingers. Introduction:.

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The effects of edema self adhesive wrap on the work of flexion in a cadaveric hand

The Effects of Edema & Self Adhesive Wrap on the Work of Flexion in a Cadaveric Hand

Samuel D Buonocore MD


Purpose
Purpose: Flexion in a Cadaveric Hand

  • To determine if the application of self adhesive wraps increase the work of flexion when hand therapy is initiated in edematous fingers.


Introduction
Introduction: Flexion in a Cadaveric Hand

  • Forces generated in a repaired tendon are likely to be greater given the presence of edema, joint stiffness, muscle contracture, and the presence of the suture material within the tendon.

  • Early active protocols are often started within 24 hours of surgery and because edema can be significant 48 hours postoperatively, it is a common clinical scenario for hand therapy to be initiated in edematous digits.

  • To address this problem, self-adherent wraps are used in the postoperative period to try to eliminate edema. This study aims to determine if the presence of self-adherent wraps increase the work of flexion during early motion protocols.


Materials and methods
Materials and Methods: Flexion in a Cadaveric Hand

  • A single fresh-frozen cadaveric hand with the distal 1/3 of the forearm intact was obtained. Flexor digitorum profundus tendons & flexor pollicis longus tendons were identified and dissected in the forearm,

  • Excursion of the flexor tendons for each of the digits was measured, the hand was then placed in a tensile testing machine, force excursion curves were generated for various clinical scenarios, including varying amounts of edema and the presence of two types of self adherent wraps.

  • Work of flexion (WOF) was calculated from the force excursion curves.


Results
Results Flexion in a Cadaveric Hand :

  • Statistically significant increases in the WOF were noted for each of the clinical scenarios simulated, compared to the fingers baseline values for the WOF.

  • The increase in the WOF noted after the application of self adherent wraps was greater than the increase noted for moderate edema.

  • The effects on WOF were additive when both edema and self adherent wraps were present. The results were consistent among all 5 fingers tested.


Conclusion
Conclusion: Flexion in a Cadaveric Hand

  • Both the presence of edema and self adherent wraps increases the work of flexion in fingers in this cadaveric model.

  • Therapists and surgeons should be aware of the potential for increased stress placed on tendons when early motion protocols are initiated in these situations.

  • We recommend the removal of self adherent wraps before the therapy session begins, this is especially true if edema is also present.


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