After Care and Therapy
Flexor Tendon Repair
Flexor tendons of fingers and thumb are delicate structures and require well lubricated smooth tendon surface to function properly. Tendons are cut by sharp lacerations and require surgical repair. Unfortunately when the tendon heals, it loses the smooth surface because of scarring, which causes problem with its normal function. It is therefore important that a prolonged postoperative splinting and specialised therapy is undertaken to minimise this scarring so that the tendon heals without adhesions to the structures around it.
The operation is carried out under General or regional anaesthesia. Unless there are other reasons to keep you in hospital, the operation is a day procedure. On discharged your hand and wrist will be in a half plaster extending from below the elbow up to the finger tips. You should keep the hand elevated in a sling to reduce swelling.
0 – 4 Weeks
You will attend the OT (Occupational Therapy) department within 4 – 5 days of the operation and the plaster will be removed. A thermoplastic splint will be made for you to keep your wrist at 0 degrees and finger knuckles (MCPJ) at 30 degrees of flexion. This splint will be on the back of hand allowing you to bend (flex) your fingers gently and straighten (extend) them up to the splint (30 degrees). You will be asked to do active gentle flexion and extension several times in the day. Some passive stretching will be undertaken by the therapist. At night time your fingers will be strapped by Velcro so that no inadvertent movements take place.
You will be seen in the clinic at 2 weeks for removal of stitches and general check on your progress.
4 – 8 Weeks
At four weeks it may be necessary to adjust the splint depending on your progress. Usually wrist is now kept at about 30 degrees of extension which allows better finger flexion. Active and passive exercises are continued. No resisted exercises are allowed at this stage.
8 – 12 Weeks
Day time splinting is discontinued but continued at night time for another 4 weeks. You can start doing active extension and flexion outside the splint but with minimal resistance or force. You will be encouraged to make full fist, half fist and hook fist. Passive movements and stretches will continue as before under the guidance of the therapist.
All splinting can now be discontinued. . You will be advised to start using your hand for normal use. Even at this stage there will be less that full movements in the finger. With continued use and exercise the finger will continue to improve for the next 12 months.