Flexor Tendon Repair — Zones I-IV Early Active Place and Hold

University of Virginia Orthopaedic Surgery

Weight-Bearing

NWB surgical UE

Key Restrictions

NOT for patients starting therapy at or beyond postop day 10; requires ≥4-strand repair and surgeon confirmation; do not start if significant edema/stiffness; no composite wrist+finger extension; no resistance until 8-10 weeks; WHFO dorsal block full time including sleep; exercises every 1-2 waking hours

Timeline & Phases

Phase 1 (0-3-5 days): dorsal block splint; Phase 2 (3-9 days to 4 wks): PROM (Modified Duran) + place-and-hold exercises, active PIP extension; Phase 3 (4-6 wks): progress place-and-hold to active tenodesis, AROM wrist; Phase 4 (6-12 wks): discontinue orthosis, joint blocking, resistance from week 8

Notes

4 phases; requires ≥4-strand repair; PROM Modified Duran warmup always; place-and-hold: passively flex fingers/extend wrist, actively hold; active MCP motion limited to 30-40°; if persistent lag, may wean orthosis at week 5 per physician; exercises every 1-2 waking hours

Published

09/2024