# Effectiveness of Peripheral Nerve Block for Early Active Exercise: Three Cases of Pyogenic Flexor Tenosynovitis

## TL;DR

This paper presents three cases where peripheral nerve blocks helped improve hand mobility after surgery for a specific infection, but extension range remained limited.

## Contribution

The study demonstrates the use of peripheral nerve blocks to enable early active exercise in pyogenic flexor tenosynovitis cases.

## Key findings

- A pulp–palmar distance of 1 mm was achieved within one week post-surgery under PNB in all cases.
- All cases were rated as 'good' in Flynn's functional evaluation at the last observation.
- Extension range of motion remained limited at the final observation despite improved flexion.

## Abstract

To prevent limitations in the range of motion after hand surgery, it is crucial to minimize scar tissue formation and adhesions. Thus, it is important to initiate active hand exercises during the early postoperative period. Peripheral nerve blocks (PNBs) may be employed for active hand exercises as they minimize postoperative pain. We reported three cases of pyogenic flexor tendonitis in which PNB was administered postoperatively, and changes in the range of motion were observed. In all cases, a pulp–palmar distance (PPD) of 1 mm was achieved within 1 week after surgery under PNB, and all cases were evaluated as “good” in Flynn's functional evaluation at the last observation. However, PPD worsened at 3 weeks postoperatively, and all patients exhibited limited proximal interphalangeal joint extension at the final observation. Although our method effectively improved the flexion range of motion, additional measures should be taken to improve the extension range of motion.