A Cochrane review [Abstract] 1 [withdrawn from publication] included six studies on the optimal rehabilitation strategy after surgery for flexor tendon injuries in the hand, with a total of 464 subjects. One trial compared continuous passive motion (CPM) with controlled intermittent passive motion (CIPM) and found a significant difference in mean active motion favouring CPM (WMD 19.00 degrees, 95% CI 15.11 to 22.89). One trial compared a shortened passive flexion/active extension programme with a normal passive flexion/active extension mobilisation programme, and reported (without data) a significant reduction in absence from work of 2.1 weeks in favour of the shortened programme. Other trials compared active flexion with rubber band traction, early controlled active mobilisation with early controlled passive mobilisation and dynamic splintage versus static splintage. No trials found significant differences in overall functioning or complication rate.
Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison) , by inconsistency (heterogeneity in interventions and outcomes) and by potential reporting bias (trials only partly reported).
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