Opponesplasty — Early Active Motion

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

Weight-Bearing

NWB surgical UE

Key Restrictions

Dorsal thumb spica orthosis (wrist neutral, thumb max palmar abduction/rotation) all time except bathing/exercises; avoid simultaneous wrist/thumb/finger extension; avoid thumb adduction until 3 weeks; no lifting >2 lbs; if autologous or allograft used default to conservative; resting abduction angle monitored as transfer tension indicator

Timeline & Phases

Phase I (7-10 days to 3 weeks): active opposition 10 reps in gravity-eliminated plane (forearm neutral) with wrist neutral then 30° flex; week 1 — monitor resting and active abduction angles for transfer tension; week 2 — tripod pinch to IF and MF when resting abduction 40-50°, progress to picking up small light objects; week 3 — strengthening/coordination/underwater exercises, ADLs with limited thumb abduction range; orthosis (wrist neutral, thumb max palmar abduction) all time except bathing/exercises; begin weaning week 3 for light functional seated tasks; Phase II (4-7 weeks): continue increasing thumb AROM; functional activities + progressive strengthening; E-stim or biofeedback; mirror feedback/whirlpool/vibration; orthosis at night and heavy activities; Phase III (8-10 weeks): progressive strengthening; progressive weightbearing; no restrictions; return to heavy work/leisure at 12 weeks

Notes

UW Health / UnityPoint Health - Meriter Rehabilitation; OT-based; one PDF shared with Opponesplasty Conservative protocol; active motion begins at first appointment (7-10 days); key metric: resting abduction angle 40-50° indicates adequate transfer tension before progressing to tripod pinch; orthosis wrist in neutral (vs. 10-20° flex in conservative); donor activation: FDS — block ring MPJ + flex PIP + oppose; palmaris longus — flex wrist + oppose; EDM — extend small MPJ + oppose; autologous/allograft bridge: default to conservative; published April 15, 2022

Surgeon / Author

UW Health Orthopedic Surgery; UnityPoint Health - Meriter Rehabilitation

Published

2022-04-15