Wide Awake Flexor Tendon Repair and True Active Movement Rehabilitation: The Saint John Protocol

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Presenters: Don Lalonde, MD, FRCSC and Amanda Higgins, BSc. OT, OT Reg (NB)

Format: 45 minutes presentation. 15 minutes Q&A

Webinar description:
More and more surgeons are using wide awake flexor tendon repair. Video clips of intraoperative wide awake flexor tendon repairs will illustrate how this approach decreases post-operative rupture and tenolysis rates. Intraoperative movement after flexor tendon repair will show why it is that we should no longer be doing full fist movement in early protected movement protocols. Full fist can catch the repair on hard pulley edges and cause a gap when the PIP joint is flexed 90 degrees. Full fist place and hold can cause buckling and jerking of the repair in live patients. This will also be shown with video. True active movement of up to half a fist is a safer way of providing 5-10mm of FDP glide as we will demonstrate in live patients. The Saint John protocol of early protected movement will be provided in detail. It is based on pain-guided hand therapy and data provided with wide awake flexor tendon repair.

Learning Objectives:
At the end of the presentation, participants will be able to:

  1. Recognize differences of true active movement vs. place and hold in live patient flexor tendon repair videos with active movement
  2. Recognize with video why up to half a fist of early protected movement is safer than full fist movement to avoid gap and rupture after surgery
  3. Recognize why up to half a fist is all that is required to get 5-10mm of profundus glide after flexor tendon repair
  4. Recognize why physiologically normal true active movement after flexor tendon repair is safe and effective.

Presented by Don Lalonde, MD, MSc, FRCSC and Amanda Higgins, BSc. OT, OT Reg (NB)
Originally presented June 2016
Duration:  One hour
CE Credit:  1 continuing education hour, or 0.1 CEU
Pricing:
Members $35
Student Members $20
Non-Members $55
Student Non-Members $30

* The ASHT Webinar Committee conducts an audit of webinars to ensure that the content is keeping up with the latest science and research. Please note that this webinar may be updated in the future. At that time, the purchased webinar will no longer be available for view.