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.

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