Finger flexor tendon
repair
Alternative protocol
Information for patients
Hand Therapy
Patient's name:
___________________________________________________________
Date of surgery:
___________________________________________________________
Your therapist is:
___________________________________________________________
Statements
Complying with the instructions/treatment advice given by your
Therapist, and in this booklet, aims to provide you with a good
outcome. However, this is not always guaranteed and there is always a
risk of complications which affect the overall result.
We must seek your consent for any procedure or treatment beforehand.
Staff will explain the risks, benefits and alternatives where relevant
before they ask for your consent. If you are unsure about any aspect of
the procedure or treatment proposed, please do not hesitate to ask for
more information.
Introduction
This booklet has been designed specifically for patients who have had
repair of their finger flexor tendon/s.
These tendons run from the forearm to the fingers and flex (bend) your
fingers into a fist.
The repaired tendon is much weaker than normal and will take about
12 weeks to recover full strength.
page 2 of 12
The information and advice in this booklet is intended to be a guideline
and should be followed with the advice given by your therapist and
doctor.
Taking your pain killers as prescribed will help you to follow your
exercise regime.
Flexor tendon repair early active movement
regime
What can I do in the first 4 weeks after my operation?
Splinting:
The tendon is very weak after your operation and you need to wear a
protective splint which will help prevent you from over stretching or
breaking the tendon.
The splint will be made by your therapist and must be worn all the time
for 4 weeks, and at times for 2 weeks after that.
Do not remove or alter your splint as this may cause your tendon
to break and you will require further surgery.
It is important that your splint is comfortable to wear.
If any of the following occur contact your therapist as soon as possible:
1. Pins and needles sensation other than that you may already have
2. Pain caused by the splint
3. Any areas of pressure
4. Defects in the splint
5. Any changs in the circulation, for example, changes in colour or
temperature of your hand
6. Any increase in swelling
page 3 of 12
What exercises should I do?
The following exercises should be performed every ............. hours
throughout the day:
Passive:
Push each finger into the palm of your operated hand, using your other
hand and hold for 20 seconds.
Repeat ............. times
Active:
Make a fist with all the fingers together on your operated hand and then
straighten all fingers fully until your nails touch the top of the splint.
Repeat .............. times
Do not push the fingers straight with the other hand or you could
break the tendon.
You also need to maintain the movement of uninjured joints (shoulder,
elbow and thumb) which are not held in the splint, as advised by your
therapist.
What should I do if I suddenly loose movement or feel
a snap in my operated fingers?
You should contact the Hand Unit immediately on:
• 0114 275 2325
Or attend your local A&E if out-of-hours.
page 4 of 12
Other important information
Keep your hand raised above the level of your heart at all times (except
when doing your exercises) to prevent swelling.
Do not attempt to clean your hand as you may break the repaired
tendon.
Do not use the operated hand for any activity at all apart from the stated
exercises as your tendon may break.
Do not drive any vehicle - your therapist / doctor will advise you when
to return to driving.
What can I do between 4 to 6 weeks after my
operation?
Start date: _________________________
With the advice of your therapist your splint can now be removed at
times during the day and for exercise.
Remember that your repaired tendon is still very weak and at risk of
breaking.
What can I do?
1. Wash your hand as advised by your therapist
2. Keep your hand raised if it is still swollen. Your therapist may also
advise you to do "contrast bathing".
3. Begin scar massage if your wound is healed, as shown by your
therapist using a rich moisturising cream, for example, E45
cream, Nivea or Diprobase.
page 5 of 12
Please:
a. Do not use your operated hand for any activity at all other than
your exercises
b. Do not push your fingers or wrist back straight with your other
hand as these activities may break your tendon.
What exercises can I do 4 weeks after my operation?
You should do these exercises every .............. hour/s .............. times.
Fingers
Ensure all exercises are done with your wrist
straight.
1. Keeping your fingers straight, bend and then
straighten the knuckles.
2. Keeping the knuckles straight, bend and
straighten the tip and middle joints of the fingers.
page 6 of 12
3. Make a fist and then straighten the fingers.
Wrist
Do the exercises as advised by your therapist.
With your fingers bent slowly move your wrist forwards and backwards.
Passive exercises:
Continue at 4 weeks after your operation
You should do these exercises every .............. hour/s .............. times.
1. Using your other hand, bend the whole finger down into the palm
and hold for 20 seconds.
page 7 of 12
What can I do at 6 weeks after my operation?
Start date: _________________________
1. Us e your hand for light activities such as:
•
•
•
•
•
Washing / dressing / brushing your hair
Holding cutlery
Holding a half pint glass / mug / cup and saucer
Writing for short periods of time (about 15 minutes)
Typing on a computer / using a remote control vi) Turning pages
of a book / newspaper
• Board games / jigsaws / sewing / knitting
2. Continue with scar massage.
What must I not do?
Please:
1. Do not lift / carry anything heavier than 1/2 kg / 1lb in weight
2. Do not drive any vehicle
3. Do not grip anything hard, for example, do not squeeze a ball,
turn a top or open a car door with your operated hand
4. Do not play any sports
What happens at 7 weeks after my operation?
Start date: _________________________
Your tendon is still too weak for heavy tasks as it still may break.
1. Your therapist may make a night extension splint to help straighten
your fingers and wrist fully.
2. Your therapist may teach you some extra exercises.
page 8 of 12
What can I do 8 to 10 weeks after my operation?
Start date: _________________________
You can now do a little more with your hand.
1. Us e your hands for activities such as:
• Playing snooker / pool / darts / table tennis
• Playing computer games
• Light housework, for example, dusting, washing and drying up (do
not lift heavy pots and pans), cleaning windows
• Light decorating, for example, painting
2. Continue with your exercises and scar massage as advised by your
therapist.
3. Start to work on gentle gripping exercises, as advised by your
therapist.
What must I do?
Please:
1. Do not lift anything heavy
2. Do not drive any vehicle (unless you have been told otherwise by
your therapist or doctor)
3. Do not play any sports (apart from those mentioned above)
page 9 of 12
What can I do at 10 weeks after my operation?
Your tendon is almost fully healed, but you need to avoid heavy work /
heavy lifting for a further two weeks.
1. Most activities around the home, avoiding heavy lifting.
2. Return to driving with the advice of your therapist / doctor (you
will need to inform your insurance company).
3. Continue with your exercises and massage as advised.
What must I not do?
Please:
1. Do not lift any heavy weight
2. Do not play any sports (except for those previously mentioned,
for example, snooker, pool, darts, table tennis).
What happens at 12 weeks after my operation?
Start date: _________________________
Your tendon should be fully healed and strong enough for you to begin
heavy lifting and gradually return to full activities including sports and
heavy manual work.
Your hand will feel weak but do not worry, your strength will build up
gradually with increased use.
page 10 of 12
page 11 of 12
If you have any problems or questions regarding your hand please
telephone:
0114 226 6457 or 0114 271 5799
and leave a message for your therapist.
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Working hard to fund improvements that make life better
for patients and their families
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© Sheffield Teaching Hospitals NHS Foundation Trust 2015
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PD7618-PIL3111 v2
Issue Date: October 2015. Review Date: October 2017