The postoperative dressing is removed.
A Gutter splint holding the digit in full extension is fitted to wear between exercise sessions and at night. (NOTE: active full extension Resting Pan may be used if multiple digits are replaced).
Active and Passive Range of Motion exercises are initiated 4 times a day for 10 - 15 min. The patient is cautioned against lateral stress to the digit.
If there is any lateral deviation of the digit a Bowling Alley splint may be used to control the motion at that joint.
1 week:
Taping or dynamic flexion may be initiated if passive flexion is less than 70 degrees and there is an extensor lag is less than 30 degrees.
10 weeks:
Gentle progressive strengthening may be initiated using foam and putty.
The patient should gradually be weaned off the Gutter splint.
NOTE: An average total Range of Motion of the digit is 60-70 degrees.
With erosive osteoarthritis joints become more easily swollen and inflamed. It may therefore be necessary to be less aggressive with the rehabilitation program.