Focusing on fingers with proximal interphalangeal joint flexion contractures, this study seeks to determine whether significant differences exist between the joint passive range of motion PROM improvement when receiving higher doses of daily total end range time (TERT) compared to those that receive lower doses. The study randomized a parallel group of fifty-seven fingers in fifty patients with concealed allocation and assessor blinding. Divided into two groups receiving different doses of daily total end range time with an elastic tension digital neoprene orthosis, they also participated in an identical exercise program. Patients reported orthosis wear time, and the researchers performed goniometric measurements at every session during the three-week period. The primary outcome related the time patients wore the orthosis to the degrees of improvement in PROM extension. Compared to group B (daily TERT of twelve hours), group A (TERT, twenty+ hours) showed a statistically significant greater improvement in PROM after three weeks of treatment. Group A improved by a mean of 29° compared to group B’s mean of 19° improvement. This study provides evidence that a higher dose of daily TERT can generate better results in the treatment of the proximal interphalangeal joint flexion contractures.

El conocimiento de la anatomía de los tendones flexores es importante para el tratamiento de las lesiones de estas estructuras y su pronóstico. Es imprescindible tener un buen fundamento de las estructuras de los tendones y su relación con la patogénesis de las lesiones y su reparación. El aporte vascular es un punto crítico en la reparación de los tendones flexores. Los tendones flexores extrínsecos se mantienen aplicados sobre el esqueleto de los dedos por un sistema de poleas osteofibrosas que dirigen los tendones en el sistema poliarticular sobre el que actúan. Además, están rodeados de unas vainas sinoviales que permiten su deslizamiento y los nutren, junto con los mesotendones y vínculas.