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

1st 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 5th week

Nantong regimen (active-passive method) –

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

6th week –

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

8th week –

  • Splint discontinued.

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