The use of the ICAM Splint Programme in Zone IV to VII Extensor Tendon Repairs: Patient outcomes and clinician experiences in a specialised hand unit in SA

Nicole D Mottay, Pragashnie Govender, December Mandlenkosi Mpanza


Background: The ICAM splint programme was developed in the 1980s and is known to produce favourable results in the management
of extensor tendon repairs from zone IV to zone VII. It has only become popular in South Africa over the past several years and to the
authors’ knowledge its application in South Africa has not previously been reported.
Aim: The study sought to describe the use of the ICAM splint programme following an extensor tendon repair from zone IV to VII at
a specialised hand unit in SA.
Methods: The study followed a concurrent mixed methods design. In phase one, a retrospective file audit was conducted with a sample
of patients following the ICAM programme (n=75). Phase two involved individual therapist interviews (n=3), surgeon interviews (n=2)
and a focus group with physiotherapists and occupational therapists (n=7) that had experience with the ICAM splint programme.
Microsoft excel was used to descriptively analyse phase one data and thematic analysis was used to analyse phase two data. Data were
merged and represented in a joint display.
Results: The majority of patients (83%) were male with 40% in the age range of 26-35 years old. The injuries were mainly violence
related (69%) in comparison to accidental injuries (31%) with extensor tendon zone V (40%) and VI (47%) being the most commonly
involved. Adherence was reportedly influenced by factors such as patients’ financial status, education and language barriers.
Conclusions: The results suggest that the ICAM splint programme is beneficial in managing extensor tendon repairs from zone IV
to VII. Therapists should consider factors that affect non-adherence when selecting patients for the ICAM programme to determine
its suitability. Educating patients on the ICAM splint programme is essential to facilitate adherence. Novice therapists to the ICAM
programme should receive formal training to improve confidence and skill.

Key words: ICAM splint programme, extensor tendon repair, zone IV to VII

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ISSN 0038-2337 (print), ISSN 2310-3833 (online)

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