Sagittal Band — Non-Operative — Conservative Treatment

UW Health Orthopedic Surgery; UnityPoint Health - Meriter Rehabilitation

Weight-Bearing

NWB surgical UE

Key Restrictions

No lifting/pushing/pulling >5 lbs involved UE; no WB involved UE; orthosis all times except safe hygiene

Timeline & Phases

Phase I (Initial): fabricate P1 blocking extension orthosis or RME (MCP 10–20° hyperext, IPJ free); AROM in orthosis; edema management | Phase II (4 wks): AROM in RME orthosis; restricted MCP flex with no extensor tendon subluxation | Phase III (6 wks): full composite AROM 5x/day without orthosis; orthosis all time except exercises | Phase IV (8 wks): light/moderate activities; PROM if needed; orthosis night and heavy/leisure/unsafe activities | Phase V (10 wks): initiate strengthening; discontinue orthosis; no restrictions

Notes

Non-operative management for acute (<3 wks) complete or partial sagittal band rupture; indication: inability to initiate MCP extension but able to hold in extension once passively extended; progression gate: stability of extensor tendon on MCPJ at each phase; developed collaboratively by UW Health and UnityPoint Health - Meriter Rehabilitation

Published

2022-05-24