Flexor tendon repair or graft
early active motion therapy - Belfast Protocol
Suture: 4.0 monofilament
Kessler with peripheral epitenon suture
2 days:
Splint: Standard Dorsal
Blocking Plaster splint with wrist in full flexion minus 30° (usually
30-40°), Metacarpophalangeal joints at 90° flexion and interphalangeal
joints at 0°. More recent modifications of this regime have a
less extreme flexion posture.
Early Active Exercises:
2 days post-op, commence 2 hourly exercise sessions with 2 active flexion
movements into air (proximal interphalangeal joints to 30° and distal
interphalangeal joints to 5-10°), then 2 passive flexion movements
into the palm, and 2 active extension movements back into the splint.
6 weeks:
The splint is discontinued.
The patient is started on active flexion exercises and differential gliding
exercises are initiated.
8 weeks:
Strengthening and passive
extension exercises are instituted as needed. At 12 weeks the patient may
return to work and unrestricted activities.
Therapy
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