Extensor Tendon Repair — Zones VII–VIII

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

Weight-Bearing

NWB surgical UE

Key Restrictions

No passive flexion of digits Phase I; no composite wrist and finger flexion through 6 weeks; monitor for extension lag throughout; no lifting/pushing/pulling >2 lbs; all restrictions lifted at 12 weeks; slower progression for diabetics, smokers, or patients with systemic conditions

Timeline & Phases

Phase I (3-5 days to 3 weeks): wrist cock-up orthosis 30-40° extension (dorsal orthosis allows synergistic motion), synergistic wrist motion (tenodesis) to 10-20° wrist flex for EDC (less if wrist extensors involved), finger AROM to prevent retinaculum adhesion; Phase II (3-5 weeks): synergistic motion mid-range, PROM fingers and wrist mid-range, gravity-resisted wrist extension from neutral, light isometric extensors at 5 weeks if good excursion; Phase III (5-8 weeks): D/C daytime orthosis at 5 weeks (except heavy work), unrestricted wrist ROM, progressive strengthening, avoid forceful composite flexion until 6 weeks; 12 weeks: all restrictions lifted

Notes

UW Health / UnityPoint Health - Meriter Rehabilitation; OT-based; zones VII-VIII = within and proximal to extensor retinaculum; therapist must identify which tendons involved (EDC only vs. wrist extensors) — affects tenodesis wrist flexion limit; synovium involvement over repair increases adhesion risk; discharge criteria: full composite ROM and functional grip strength without extensor lag; static progressive splinting for long extensor tightness Phase III

Surgeon / Author

UW Health Orthopedic Surgery; UnityPoint Health - Meriter Rehabilitation