Extensor Tendon Repair — Zone III Early Short Arc Motion

University of Virginia Orthopaedic Surgery

Weight-Bearing

NWB surgical UE

Key Restrictions

NOT for patients starting therapy at or beyond postop day 7; requires surgeon confirmation of central slip repair without lateral band involvement; do not start if significant edema/stiffness; PIP in extension between sessions; progressive arc limits per week; extension lag <5° to progress

Timeline & Phases

Phase 1 (0-5-7 days): postop PIP extension splint; Phase 2 (5-7 days to 6 wks): short arc motion (SAM) with wrist 30° flexion/MCP extension, template limits (day5-7: 30°, wk2: 45°, wk3: 60°, wk4: 75°, wk5: 90°, wk6+: as tolerated), PIP in extension between sessions; Phase 3 (6-10 wks): progress PIP flexion, PROM from week 7, wean day at 6-8 weeks, FO at night until week 10

Notes

Must initiate by postop day 7; SAM performed with wrist in 30° flexion and MCP in extension; extension lag <5° to progress arc; FO full time between sessions and at night until week 10; emphasis on active extension over flexion

Published

09/2024