Extensor Tendon Repair — Zones IV–VI Non-ICAM Standard Delayed Mobilization

UW Health · UW Health Orthopedic Surgery; UnityPoint Health - Meriter Rehabilitation

Weight-Bearing

NWB surgical UE

Key Restrictions

WHFO full time day and night except exercises through week 5; no composite wrist and finger flexion until 5 weeks; no full composite PROM; no lifting/pushing/pulling >2 lbs; monitor for extensor lag; Non-ICAM used when all EDC tendons repaired; restrictions lifted at 10-12 weeks

Timeline & Phases

Phase I (day 3-5 to week 5): custom thermoplastic WHFO in 45° wrist extension, MPs in neutral, PIPs/DIPs free — full time day and night except exercises; AROM uninvolved joints; week 4: AROM wrist and fingers (continue orthosis between exercises); Phase II (weeks 5-8): week 5 — composite wrist and finger flexion; week 6 — PROM wrist and fingers (not composite), D/C orthosis; week 8 — gentle strengthening; Phase III (10-12 weeks): return to all functional activities, progressive heavy work and leisure; no restrictions

Notes

UW Health / UnityPoint Health - Meriter Rehabilitation; OT-based; one PDF shared with Zones IV-VI ICAM protocol; Non-ICAM for when all EDC tendons repaired; WHFO in 45° wrist extension with MPs in neutral (more restrictive than ICAM approach); EAM begins 3-5 days post-op; criterion-based — extensor lag = halt progression; slower progression for diabetics/smokers

Surgeon / Author

UW Health Orthopedic Surgery; UnityPoint Health - Meriter Rehabilitation