This protocol is instituted when the surgeon feels that the quality of the tendon remaining after tenolysis is inadequate to stand the tension involved in the standard tenolysis protocol. This protocol is designed to reduce the chances of tendon rupture during recovery, but is not a guarantee that tendon rupture will be prevented.
0 - 1 day:
The postoperative dressing is removed.
A light dressing and edema control is applied as needed. Elevation is emphasized.
An exercise program is initiated 2 to 4 times daily as follows:
The digit is passively moved in the direction of the freed tendon and then held with active muscle contraction only. The digit is then released and actively returned to neutral position. No composite motion involving wrist and digits against the frayed tendon is allowed.
A gutter splint is fitted to place the frayed tendon on slack to be worn between exercises and at night.
Dynamic flexion splinting may be initiated as needed. The tendon is protected by the above program until otherwise instructed by the physician.