Zone 3+ Flexor Tendon Repair Rehabilitation
Date issued: November 2024
For review: November 2026
Ref: C-589/AH/Occupational Therapy/Zone 3+ Flexor Tendon repair rehab v2
PDF: Zone 3+ Flexor Tendon repair rehab.pdf [pdf] 357KB
Introduction
You have had the tendon/s that bend your finger repaired. This will need to be protected in a splint. It will take several months to regain your movement and strength.
Post operative wound care:
Routinely the wound is closed with sutures (stitches) these need to be in place for 14 days. It is important to keep the wound clean and dry until your sutures are removed. This helps to reduce the risk of infection.
Swelling management:
Reducing the swelling allows for better movement and improves post operative outcomes. Following your operation you will be given a sling to wear. It is important to wear the sling during the day until your first appointment. It’s important to remove the sling every 2 hours to move your shoulder and elbow to avoid stiffness. If the sling becomes uncomfortable to wear you can place your hand against your chest so it is higher than your heart. At rest or at night it can be elevated on pillows.
Hand Hygiene:
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To wash your arm/hand, place your forearm on the draining board/table, remove the splint keeping the wrist in a relaxed position and remember not to straighten your fingers.
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Using unperfumed soap or unperfumed wipes, wash the arm down (still with it supported on the draining board) from the elbow towards the fingers.
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Do not wash across any unhealed wounds unless advised by your therapist. Use wipes to clean between the fingers.
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Ensure the arm is dry before reapplying the splint.
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Do not extend the wrist.
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Shower wearing the splint (covered by a plastic bag/limbo)
Scar Massage
Once your wound is healed you should spend at least 5 minutes 3-4 times a day performing scar massage while wearing your splint.
Use an unperfumed moisturiser to massage into the skin, rub firmly using circular movements up/down the scar. This will flatten the scars appearance, prevent sticking/adhesions and avoid any tightness.
Splinting:
Your therapist will make a splint for you to wear out of thermoplastic material. You will need to wear the splint 24 hours a day for the first 6 weeks. You will be able to remove the splint only for hygiene purposes. The tendon repair is very delicate in the first 6 weeks following the operation. The splint is designed to protect your tendon repair but also allow for guided movement and exercise. If your splint becomes uncomfortable or irritates the skin, please contact your therapist so it can be re-moulded or altered.
Within the first 6 weeks of having your operation remember ‘You can move the hand but not use it’
We have outlined activities you may be able to resume post operatively below:
| 6 weeks (Light) | 8 weeks (Medium) | 12 weeks (Heavy) |
|---|---|---|
| Washing/shaving | Unscrewing jars/opening tins | Using a knife |
| Fastening clothes/shoelaces | Washing up | Gardening |
| Brushing hair | Holding a mug of tea/glass | Carrying shopping |
| Writing/typing | Using a key to open a door | Lifting children |
| Using your phone | Driving | Sports: Swimming, cycling, gym workouts |
Exercises Weeks 1-2
Your therapist may advise on the following exercises
The following exercises should be completed 10 times every hour (where possible) for the first six weeks:
Active ½ fist
Exercises Weeks 2-6
Exercises: Continue with the previous exercises but you can work on gradually achieving a full fist (You may start the following exercises as advised by your therapist).
Exercises 6 weeks +
Discard the initial exercises. Your therapist may advise weaning off the splint around 5-6 weeks following your operation. You can begin some light everyday activities but should not lift items heavier than a cup of tea. You should continue to wear your splint at night for a further 2 weeks.
Tendon gliding exercises: Please repeat……………
Flat Tabletop Movement
Bend the knuckle joints (base of your fingers) forward without bending any other joints of your fingers. Straighten your fingers.
Full Fist Movement
Make a fist with your hand without clenching it tight.
Exercises
Hook Fist Movement
Hold your fingers straight. Bend your fingers down only at the top joints and middle joints. Straighten your fingers.
Straight Fist Movement
Bend the knuckle joints (base of your fingers) forward without bending any other joints of your fingers. Then bend your fingers at the middle joints but keeping the tip of your fingers straight. Straighten your fingers.
Exercises 8 weeks+
Place putty in the palm of your hand, curl your fingertips into a fist around the putty. Reshape it and repeat.
Repeat………….
Hold a spring grip strengthener or other grip strengthener. Squeeze, release and repeat.
Repeat……………
