Is relief for personnel shortages in sight?

In the Case Report "Early Controlled Motion Following Flexor Tendon Graft" (July 1988), the authors gave an excellent overview of the physio­ logical rationale for early controlled motion. I must express my concern, however, at their conclusion as stated: "The good functional results achieved suggest that a rehabilitation regimen consisting of the palmar pulley sys­ tem, a PIP joint block, and a 6-week program of early controlled motion is effective in inhibiting the formation of peritendinous scarring, joint con­ tractures, and other complications that commonly occur secondary to flexor tendon grafts and repairs in zone 2 of the hand" (p. 463). I feel that such a global state­ ment is not supported by this isolated case study of a flexor tendon graft on an 8-year-old girl. It is well accepted that children have far superior surgi­ cal results than adults with flexor ten­ don repair or grafting. I am con­ cerned that the inexperienced therapist treating patients with flexor tendon injuries will assume that this rehabilitation regimen will result in perfect results. Those of us who have been treating tendon injuries for some years believe that this is one of the most difficult areas of rehabilita­ tion. Even with our best efforts we often are unable to obtain what we would consider optimal results. I would hope the authors would be less enthusiastic in assuming that their regimen works well with pa­ tients of all ages. Judy C. Colditz, OTR/L Raleigh, North Carolina