Flexor Tendon Repair — Zone 2 (Early Active Motion Protocol)

Lahey Hospital & Medical Center · M. Miles, OTR/L, CHT; Lahey OT Department

Weight-Bearing

N/A

Key Restrictions

Dorsal Block Orthosis at all times 0-2 wks; Manchester Short Orthosis from 2 wks, worn at all times until 4 wks then weaned; orthosis discontinued by 6 wks; avoid full or forceful finger flexion throughout; light ADLs only at 6-7 wks; grip strengthening 7-10 wks

Timeline & Phases

Phase 1 days 3-5 to 2 wks (DBO/passive + active-assist); Phase 2 11-14 days (Manchester orthosis/tenodesis); Phase 3 15-28 days (3/4 to full fist); Phase 4 4-5 wks (orthosis weaned at home); Phase 5 6-7 wks (light ADLs/gentle strengthening); Phase 6 7-10 wks (grip strengthening/return to work)

Notes

OT-authored; incorporates Modified Duran and St. John Protocol elements; 4-6 strand core suture repair required for early AROM; Manchester Short Orthosis shown to prevent PIP flexion contractures; relative motion orthosis (yoke) option for FDP adhesion

Surgeon / Author

M. Miles, OTR/L, CHT; Lahey OT Department

Published

2023-01