ABSTRACT:The effects of different hand motions and positions used during early protected motion rehabilitation on tendon forces are not well understood. The goal of this study was to determine in vivo forces in human flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) tendons of the index finger during active unresisted finger flexion and extension. During open carpal tunnel surgery (n ¼ 12), flexor tendon forces were acquired with buckle force transducers, and finger positions were recorded on video while subjects actively flexed and extended the fingers at two different wrist angles. Mean in vivo FDP tendon forces varied between 1.3N AE 0.9N and 4.0N AE 2.9N while mean FDS tendon forces ranged from 1.3N AE 0.5N to 8.5N AE 10.7N. FDP force increased with active finger flexion at both wrist angles of 08 or 308 flexion. FDS force increased with finger flexion when the wrist was in 308 flexion, but was unchanged when the wrist was in 08 of flexion. Tendon forces were similar regardless of whether the fingers were moving in the flexion or extension direction. Active finger flexion and extension with the wrist at 08 and 308 flexion may be used during early rehabilitation protocols with limited risk of repair rupture. This risk can be further decreased for a FDS tendon repair by reducing wrist flexion angle. ß

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III (controlled trial without randomization).