Extensor Tendon Repair — Zone IV Delayed Mobilization

University of Virginia Orthopaedic Surgery

Weight-Bearing

NWB surgical UE

Key Restrictions

PIP and DIP immobilized in full extension without fail; avoid tight fisting until week 10+; limited arc motion begins week 4 only if extension lag <10°; wean day at 6-8 weeks; FO at night until week 10

Timeline & Phases

Phase 1 (0-10-14 days): postop finger splint PIP+DIP in extension; Phase 2 (2-4 wks): static FO PIP+DIP full extension full time; Phase 3 (4-10 wks): limited arc PIP+DIP (wk4: 0-30°, wk5: 0-45°, wk6: progressive, wk7: PROM + dexterity + grip strengthening), wean day 6-8 wks, FO night until week 10

Notes

Zone IV = dorsum of hand; differs from Zone III in that both PIP and DIP are immobilized; extension lag <10° progression criteria; dexterity and progressive grip strengthening from week 7; no heavy lifting until week 10+

Published

09/2024