Flexor Tendon Repair — Zones I-IV Delayed Mobilization

University of Virginia Orthopaedic Surgery

Weight-Bearing

NWB surgical UE

Key Restrictions

Use when therapy delayed >10 days postop OR significant edema/stiffness present; no active finger flexion; no composite wrist+finger extension; do not use surgical hand for self-care; no resistance strengthening until 8-10 weeks; WHFO dorsal block full time including sleep

Timeline & Phases

Phase 1 (0-3-5 days): dorsal block splint; Phase 2 (3-9 days to 4 wks): PROM only (Modified Duran), active PIP extension/intrinsic motion, reverse blocking; Phase 3 (4-6 wks): active tenodesis, AROM wrist, extrinsic flexibility; Phase 4 (6-12 wks): discontinue orthosis, joint blocking, resistance from week 8

Notes

4 phases; indicated for delayed therapy onset >10 days or high edema; PROM Modified Duran as warmup before all sessions; Zone 1 injuries may limit DIP extension per surgeon; may use relative flexion/extension orthosis for lag or PIP contractures in Phase 4

Published

09/2024