الفهرس 
Title : Relative motion protocol versus place and hold protocol after hand zone II flexor tendon repair
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Abstract
The present study was conducted to explore the effect of a relative motion protocol and compare it to those of a place and hold protocol on the outcomes [Range of Motion (ROM), Hand grip strength, and Michigan Hand Questionnaire (MHQ)] after zone II flexor tendon repair. Subjects and Methods: Sixty patients who underwent zone II flexor tendon primary direct 4-strand repair participated in this study. Patients’ age range was between 20 to 35 years. They were collected from Cairo University Hospitals and distributed randomly into two groups: group (A) contained 30 patients (30 operated fingers) who received a relative motion protocol, and group (B) contained 30 patients (30 operated fingers) who received place and hold protocol. Postoperative medical treatment (medications including pain killers and antibiotics, and dressings over surgical lines) was introduced for every patient in each group. Finger goniometer was used to measure the Interphalangeal (IP) joints active ROM of the operated fingers at 4th, 6th, 8th, and 12th postoperative weeks. Hand dynamometer was used to measure hand grip strength of each patient at 12th postoperative week. The MHQ was provided for each patient to be filled in at 12th postoperative week. Results: Relative motion protocol group showed significant statistical improvement over place and hold protocol group in terms of IP joints active ROM of the operated fingers at 4th [Mean Difference (MD) = 11.63, p = 0.001], 6th [MD = 7.07, p = 0.01], 8th [MD = 7, p = 0.009], and 12th [MD = 7.54, p = 0.005] postoperative weeks; operated hand grip strength (% of normal hand) at 12th postoperative week [MD = 6.37, p = 0.001]; and all scales of MHQ at 12th postoperative week [MD = 13.5, p = 0.001; MD = 6.56, p = 0.02; MD = 8.67, p = 0.001; MD = -6.83, p = 0.001; MD = 6.86, p = 0.006; and MD = 6.93, p = 0.006 respectively]. Conclusion: Relative motion protocol is superior to place and hold protocol in improving the outcomes after hand zone II flexor tendon repair while both show no tendon ruptures.