Article Review: Relative Motion for Extensor Tendon Repair zone V-VI? Is a night-time resting hand orthosis beneficial?

Hirth, M. J., Hunt, I.,  Briody, K.,  Milner, Z., Sleep, K., Chu, A., Donovan, E. &  O’Brien, L. (2021). Comparison of two relative motion extension orthotic programs following surgical repair of finger extensor tendons in zones V-VI: A randomized equivalence trial. Journal of Hand Therapy-to be published.

relative motion splint

The Skinny:  Following a zone V-VI tendon repair, relative motion splint is an effective option in providing adequate protection and preventing tendon rupture/attenuation.  There is variability in relative motion splinting approaches, including replacing the relative motion orthosis with a larger orthosis overnight or adding a wrist orthosis.  Due to this variability, the authors looked to determine if the splinting regime mattered.  The study compared two splinting regimes following an extensor tendon repair in zone V-VI.  Group one was a relative motion orthosis alone, and group two was a relative motion orthosis and a night-time orthosis.   

In the Weeds: The study compared two splinting regimes (relative extension splint) following an extensor tendon repair in zone V-VI.  Group one was a relative motion orthosis alone, and group two was a relative motion orthosis and a night-time orthosis following.   They termed the groups as follows RME and wrist orthoses worn at the same times are terms ‘RME plus,’ and without a wrist, orthosis was termed‘ RME only.’  A total of 32 subjected were enrolled in the study and 17 were randomized into the RME and night-time splinting group, and 15 were enrolled in the RME at all times groups.  

Outcomes measures included a range of motion, grip strength, return to work, pain, hand function, satisfaction, and orthotic adherence. 

Bringing it Home:  Both interventions produced similar outcomes and with no increase in rupture rate and similar results in the outcome measures.  

Rating: The authors recommenced tailoring therapy interventions based on patient needs rather than being protocol-based.  The study limitations include a small sample size.  Also, it was a multisite study, so difficult to control for variations in therapeutic approaches and surgical techniques.  A night-time resting hand orthosis may provide more comfort for patients.

4 Comments

  1. Bonnie krafve on May 31, 2024 at 7:33 pm

    my mother’s middle finger is severely pulling over top of her ring finger. Doc said tendon damage. He put her in this type of splint which isn’t going to help stretch the tendon back to the middle. HOW is this supposed to fix her hand??

    • Miranda Materi on September 26, 2025 at 7:27 am

      Hello, It depends on the degree of the injury. I would recommend your mother see a certified hand therapist

  2. Clara Morales on August 26, 2025 at 1:41 pm

    Hello ,
    I would like to know how many weeks is time right time to use de the relative motion splint for extensors and flexors tendons?

    • Miranda Materi on September 26, 2025 at 7:28 am

      like most things, it depends. It depends on the severity of the injury and if there was a repair done.

Leave a Comment






More To Read

Rapid Review: Is Finger Splinting Necessary after Flexor Tendon Repair?

December 13, 2025

Outcome of Flexor Tendon Repair Using Eight-Strand Core Stitch Without Postoperative Finger Splinting Reference: El-Gammal, T. A., Kotb, M. M., Ragheb, Y. F., El-Gammal, Y. T., & Anwar, M. M. (2024). Outcome of Flexor Tendon Repair Using Eight-Strand Core Stitch Without Postoperative Finger Splinting. HAND. https://doi.org/10.1177/15589447231220686 The Skinny: The purpose of this study was to…

Read More

Functional Home Exercises for Patients with Wrist Instability

June 29, 2024

Functional Home Exercises for Patients with Wrist Instability Ever wondered what brushing your teeth, dressing, making a U-turn, and playing sports have in common? They all rely on a stable wrist. Wrist stability is crucial for everyday activities, supporting wrist proprioception, coordination, motor control, stability, and mobility (Wietlisbach, 2019). For patients recovering from a wrist…

Read More

7 Tips for your Osteo Arthritis Patients!

April 18, 2021

7 Tips for your OA Patients!  Managing Osteoarthritis in the Hand Our hands are one of the most intricate structures in the human body. They are composed of a network of tendons, ligaments, and nerves that make it possible to perform daily tasks such as unlocking a door, peeling an egg, or sending an email…

Read More

Putting Occupation in Hand Therapy

February 5, 2019

It was early in my career, maybe a year out of school. I was working with a veteran physical therapist that had been practicing for thirty plus years. She was somewhat intimidating and one of those old school physical therapists that thrived on being aggressive. We were chatting about what areas of occupational hand therapy…

Read More
Envelope_1

Sign-up to Get Updates Straight to Your Inbox!

Sign up with us and we will send you regular blog posts on everything hand therapy, notices every time we upload new videos and tutorials, along with handout, protocols, and other useful information.