Extensor Tendon Repair — Zones V-VI Delayed Mobilization

University of Virginia Orthopaedic Surgery

Weight-Bearing

NWB surgical UE

Key Restrictions

WHFO (wrist ≥15° extension, MCP in extension allowing IP flexion) full time including sleep; avoid concurrent wrist and finger flexion; no resistance strengthening until 6 weeks; orthosis worn full time except hygiene from week 3

Timeline & Phases

Phase 1 (0-2 wks): volar wrist/finger extension splint; Phase 2 (2-4 wks): WHFO full time, AROM IP of involved digit, proximal tendon gliding from week 3; Phase 3 (4-6 wks): WHFO full time, tendon glides (hook/straight/composite/intrinsic extension) from week 5, AROM wrist; Phase 4 (6+ wks): wean orthosis, resist grip from week 7, resistance to repair from week 8, night orthosis until week 8

Notes

4 phases; Zones V-VI = MCP level / dorsal hand; WHFO wrist ≥15° extension + MCP extension with P1 block forearm-based; additional full digit support attachment for night; edema glove and compression sleeve throughout; avoid end-range wrist flexion during hygiene

Published

09/2024