Flexor Tendon Repair — Zone 1 & 2 (Primary Repair / Modified Duran Protocol)

Lahey Hospital & Medical Center · A. Hunter, MD; G. Kasparyan, MD; M. Song, MD; E. Tolo, MD; P. Ryle, MS, OTR/L…

Weight-Bearing

N/A

Key Restrictions

Dorsal Block Splint (wrist 10-20 deg flexion, MCP 40-50 deg flexion, IPs neutral) day and night until 5.5-6 wks; no active composite fist until 3.5-4 wks; no resistive use until ~8 wks; cleared for full dynamic tasks/interval sports at 12 wks per MD

Timeline & Phases

Phase I 0-2 wks (passive PROM + place-and-hold/modified Duran); Phase II 3.5-4+ wks (active composite fist/tenodesis); Phase III (hook and straight fist/tendon gliding); Phase IV (isolated joint blocking); Phase V (splint d/c wk 6); Phase VI wk 8+ (resistive/return to full activity wk 12)

Notes

Older Lahey Zone 1-2 protocol (2017); uses Pyramid of Progressive Force framework (Groth 2004); caution with place-and-hold if moderate-severe edema (increased rupture risk); adhesion grading system guides progression; see also newer 2023 early AROM Zone 2 protocol

Surgeon / Author

A. Hunter, MD; G. Kasparyan, MD; M. Song, MD; E. Tolo, MD; P. Ryle, MS, OTR/L, CHT

Published

2017-08