PIP DIP joint release therapy

1 day:

The postoperative dressing is removed.

A light dressing and edema control are initiated as needed. Elevation is emphasized.

Active and Passive Range of Motion exercises are initiated 15 min/hr.

Splinting as indicated:

Dorsal Capsulotomy/Capsulectomy (usually performed with extensor tenolyses)

Generally flexion is stressed using dynamic splinting between exercise sessions, and at night particularly with MCP capsulotomy/capsulectomy.

An extension Gutter or Resting Pan is sometimes necessary at night as an extensor tenolysis is frequently done along with the dorsal capsulotomy (see specific procedure).

Volar Capsulotomy/Capsulectomy usually performed with flexor tenolyses or subtotal palmar fasciectomy.

Extension is stressed using a full extension Gutter splint or Resting Pan between exercises and at night.

NOTE:

Splinting programs for all capsulotomies are varied and must be adjusted to the individual needs of the patient.

Taping may be used as needed to increase Passive Range of Motion.

Functional Electrical Stimulation or Standard Electrical Stimulation may be initiated within 48 hours postop to assist in tendon excursion.

6 weeks:

Gentle strengthening is initiated using putty and a hand helper.

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