Extensor Tendon Repair

Reference Number: HEY-273/2019
Departments: Physiotherapy
Last Updated: 28 February 2019

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Introduction

This leaflet has been produced to give you general information about your procedure. Most of your questions should have been answered by this leaflet. It is not meant to replace the discussion between you and the healthcare team, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the health care team.

What is an extensor tendon?

The extensor tendons attach muscles in the forearm, to bones of the fingers and thumb. As the muscles contract, the tendons slide over the back of the hand and wrist, thus straightening the fingers and thumb. A damaged tendon needs to be repaired, in order for the hand to function properly.

Can there be any complications or risks?

Tendons are complex, intricate structures that are vulnerable following repair. In order for them to function properly following your operation, it is important that you exercise your hand regularly and only as advised.

Too much, or incorrect exercise may cause the repaired tendon to snap. Too little exercise may result in the tendons becoming stuck down with scar tissue, making them ineffective Forcing the fingers/thumb to bend or removing your splint when advised not to do so will place the repair at serious risk.

Splint

A splint is made to protect your tendon whilst it heals. It is vital that you DO NOT remove the splint until advised to do so by your doctor or physiotherapist.

Elevation

Swelling is a normal reaction to surgery, however, it is important to limit this as much as possible.

Wear your sling during the day for the first 3-5 days following surgery
Keep your hand elevated when wearing your splint.
Elevate your hand on pillows at night.
If your hand remains swollen, continue the elevation until it settles.

Exercise

The physiotherapist will demonstrate these exercises to you, and you should continue to do them regularly at home.

Remove ONLY the straps across your fingers/thumb before doing the exercises.

Use your unaffected hand to lift your thumb/fingers to the straight position, then let go keeping the injured thumb/fingers as straight as possible. Then allow them to return to the splint and rest.
Gently bend the thumb/finger joints, as if scratching the splint, and then allow the fingers/thumb to straighten back out on the splint.

Do each exercise ________ times every ______ hours.

Recovery Period

A tendon will repair by forming a scar, rather like a cut on the skin. However, a tendon takes much longer to heal, and remains at risk of re-rupture for several weeks after the skin wound has healed.

This is only a guide and may vary according to individual injuries.

0 -2 weeks Splint worn at all times. Exercises done in the splint.

2 -4 weeks Splint may be removed for gentle exercise and hand washing only then reapplied.

4 -6 weeks Splint worn when sleeping and when at risk as advised. Can commence light functional activities e.g. washing and dressing.

6+ weeks Splint may be discarded. Gradually return to normal activities.

7+ weeks May return to driving when safe to do so