Self Adherent Wraps such as CobanTM and Their Effect on Function and Force of Flexion in the Digits
P.S. Mohan, MD, M. Dymarczyk, PT, CHT, S. P. Mohan, and J. G. Thomson, MD
Yale University – Department of Plastic Surgery
Yale Hand and Comprehensive Microsurgery Center
Yale University – Department of Rehabilitation Services
Purpose: The use of self adherent wraps such as CobanTM during hand therapy after surgical and non-surgical intervention is common. However, although edema is reduced, does the wrap limit the range of function or increase the force needed for flexion during rehabilitation ultimately worsening the functional outcome? We study the use of self adherent wraps and their effect on function of the digits.
Methods: The study was conducted using fresh cadaveric specimens to determine both functional flexion and the force needed for flexion in digits with a self adherent wrap. The digits were initially evaluated without edema present and then with edema. Functional flexion was determined using the tip-to-palm distance when pulling on the dissected flexor digitorum profundus tendon specific for the digit. The force of flexion was determined using a scale attached to the end of the tendon and determining the force needed to flex the finger to the palm.
Results: An increase in the force needed for flexion was noted when the self adherent wrap was used in digits with and without edema. An even greater force was necessary to flex the digit when edema was present. Functional limitation was more prominent in the group with edema. However, the reduction in functional flexion and increase in the force of flexion were within expected limits when compared to baseline.
Conclusions: The benefit of using a self adherent wrap to reduce existing edema and limit further formation outweighs its overall effect on function. Edema is known to impair function of the digits particularly when it persists for a long period of time. The limitations of the self adherent wrap on the digits are not significant and its use should be encouraged.