Postoperative dressing.
3 weeks:
The postoperative dressing is removed.
Edema control is applied as needed.
A Dorsal Blocking splint is constructed with the wrist in 30 degrees of palmar flexion, the MCP's in 45 degrees of flexion, and the IP's in full extension for continual wear. Scar management is initiated as soon as sutures are removed. If digital nerves are injured as well, standard protocol for digital nerve protection is instituted.
Passive Range of Motion exercises are initiated (Duran type) are initiated, to be done 4 to 6 times daily within the splint.
4 weeks:
Electrical stimulation may be initiated to increase tendon excursion. The splint is changed to a neutral wrist splint. Active range of motion exercises are initiated.
5 weeks:
Initiate gentle progressive resistance exercises. The Dorsal Blocking splint is discontinued.
Passive extension exercises are initiated.
Dynamic extension splinting is applied as needed.
No lifting or heavy use of the hand is allowed.
8 weeks:
Progressive strengthening exercises and more vigorous passive range of motion exercises are initiated at this point.
10 - 12 weeks:
Return to normal work activities and full use of hand.