Rehabilitation following tendon repairs

Strickland “Indianapolis” method –

Uses two splints – One for rest. One for active exercise.

Splint for rest –

  • Dorsal blocking splint – wrist in 20-30° flexion, MCPJ – 50° flexion, IPJ – neutral

Splint for exercise –

  • Tenodesis splint – has a hinge @ wrist joint allowing extension of wrist. Extension of wrist causes passive flexion of fingers.

0-4 weeks –

  • Exercise –
  • Extend the wrist leading to passive composite fist à hold for 5 seconds
  • Do this 25 times per hour while awake.

4-5 weeks –

  • Active digital flexion and extension with dorsal blocking splint.
  • Tenodesis splint is discontinued.

5-6 weeks –

  • Active composite fist f/b active extension of wrist and digits.
  • Active IP flexion with MCPJ extension f/b full digital extension

6-7 weeks –

  • Blocking exercises if active tip to distal palmar crease is >3cm

8-14 weeks –

  • Progressive resistive exercise.

14 weeks –

    • Unrestricted use of hand.

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