Rehabilitation following tendon repairs

Early active motion –

Belfast method or regimen

• Splint – from elbow to the fingertips
• Wrist – midflexion
• MCPJ – <90°
• IPJ – straight
• Exercise started 48 hours after surgery
• 2-passive movement f/b 2 active movement @ 2-hour interval

1^st week –

• PIPJ active flexion for 30°
• DIPJ active flexion for 5-10°
• Subsequent week – range of motion gradually increased.
• Splint removed after 6 weeks.
• Modification of Belfast – “Billericay regime”
• MCP and wrist in 30° flexion
• 10 active finger flexion – hourly

Splint removed at 5^th week

Nantong regimen (active-passive method) –

• Splint –
• Wrist – 20-30 flexion
• MCPJ – slight flexion
• IPJ – extension
• Exercise start 3-5^th day after surgery.

0-2.5 weeks –

• Actively flex the finger with gentle force (not uncomfortable) x 20-30 times x 4 times a day
• Begin exercise with passive flexion first – 10-20 times before doing active flexion.
• Full active extension is particularly encouraged.

2.5 – 5.5 weeks –

• New splint given with wrist in 30° extension.
• Finger flexion exercise both active and passive
• Passive flexion for full range of flexion
• Active flexion as far as possible without much force.

6^th week –

• Full active finger flexion
• Splint is removed and used only in night

8^th week –

• Splint discontinued.

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