Health
Splints after flexor tendon repair
Key Points
Flexor tendon injuries are among the most common upper limb injuries seen in emergency and hand surgery departments.1 After surgical intervention, the application of splinting is pivotal in protecting the repair while movement is progressively restored. Clinicians, however, still lack reliable evidence on which splint design is optimal. Splinting practice for flexor tendon repair has evolved considerably: from early immobilisation regimens and passive and active motion protocols to the...
Flexor tendon injuries are among the most common upper limb injuries seen in emergency and hand surgery departments.1 After surgical intervention, the application of splinting is pivotal in protecting the repair while movement is progressively restored. Clinicians, however, still lack reliable evidence on which splint design is optimal. Splinting practice for flexor tendon repair has evolved considerably: from early immobilisation regimens and passive and active motion protocols to the smaller, less restrictive designs used today.234 Yet systematic reviews have repeatedly emphasised that this progression was based on case series and small, low quality studies rather than on randomised evidence.567The linked Flexor Injury Rehabilitation Splint Trial (FIRST) by Bamford and colleagues (doi:10.1136/bmj-2026-100953) fills that gap.8 This adequately powered multicentre randomised trial compared three widely used splints—a long forearm based splint, the Manchester short splint, and the relative motion flexion “mini” splint—for zone 1 and 2 flexor tendon repairs; injuries to the...