The postoperative dressing is removed. A Short Arm Thumb Spica cast is applied.
The patient is instructed in thumb IP and finger Active Range of Motion and Passive Range of Motion
3-6 weeks:
The cast is removed, and sutures are removed. The patient is placed in a short arm thumb spica (either a thermoplastic splint or cast).
6 weeks:
Cast is removed and the patient is placed in a hand-based thumb spica splint.
Active and gentle Passive Range of Motion exercises are initiated to the wrist and thumb 15 min/hr.
A Thumb Web Spacer splint is applied to be worn between exercises and at night as needed for protection.
7 weeks:
Taping and/or Dynamic flexion splinting may be initiated as needed to increase Passive Range of Motion.
Graded thenar strength building is started.
Daytime splinting is discontinued.
10 - 12 weeks:
Normal use may be resumed without restrictions. Nighttime splinting is discontinued unless first web space adduction contracture is noted.
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