Flexor and Extensor tendon repairs

Flexor and extensor tendon repairs are common surgical procedures performed to address injuries to the tendons responsible for bending (flexor tendons) and straightening (extensor tendons) the fingers and thumb. These injuries can occur due to trauma, lacerations, or other causes, and surgical intervention is often required to reattach the torn tendons and restore hand function. Hand therapy plays a vital role in the rehabilitation process after flexor and extensor tendon repairs, to administer protocols specific to zones of tendon repair and strength of the repairs

Flexor Tendon Repair:

• Protective Immobilization: After surgery, the hand is usually placed in a custom-made protective splint to keep the repaired tendons in place and protect them during the initial healing phase.
• Wound care: Appropriate wound care is crucial in the tendon healing process, this helps to prevent any infection and assist in the healing process of the repaired tendon
• Early Active/ Passive Motion: Controlled active/ passive motion exercises are initiated by the hand therapist to move the fingers gently . This helps prevent adhesions while allowing the tendon repair to heal, these exercises are dependent on which part of the tendon is repaired and the strength of the repair.
• Tendon Gliding Exercises: As healing progresses, tendon gliding exercises are introduced to facilitate smooth tendon movement within the tendon sheaths. These exercises reduce the risk of scar adhesions and help regain finger flexibility.
• Active Motion Exercises: As the repaired tendons gain sufficient strength, the patient starts active motion exercises to actively flex and extend the fingers.
• Strengthening Exercises: Strengthening exercises gradually increase as the tendon repair heals, helping to restore grip strength and overall hand function.
• Scar Management: Scar tissue management techniques, such as massage and other manual therapies, are used to minimize scar adhesions and improve tissue mobility.
• Edema Control: Swelling management techniques, including elevation, compression, and specific exercises, are used to reduce swelling in the hand.
• Joint Mobility Exercises: The therapist works on joint mobility exercises to restore full range of motion in the fingers and hand.
• Activity Graduation: The patient is guided through a gradual increase in activity complexity to challenge the repaired tendon and prepare it for functional use

Extensor Tendon Repair:

• Protective Immobilization: Similar to flexor tendon repair, the hand is typically placed in a protective splint to keep the repaired tendons in place and protect them during the initial healing phase.
• Early Controlled Mobilization: Controlled active extension exercises of the fingers are introduced early in the rehabilitation process. The therapist guides the patient to perform these exercises while ensuring that the repaired tendons are not overly stressed.
• Strengthening Exercises: Strengthening exercises are incorporated gradually to regain hand and finger strength.
• Edema Control: Similar to flexor tendon repair, techniques to manage swelling in the hand are employed.
• Joint Mobility Exercises: The therapist works on joint mobility exercises to restore the full range of motion in the fingers and hand.
• Activity Graduation: As the repaired tendons heal, the patient is guided through an increase in activity complexity to promote functional use.

In both flexor and extensor tendon repairs, the hand therapist closely monitors the healing process, modifies the therapy plan as needed, and provides education to the patient about proper care and precautions to avoid re-injury.

It's essential to follow the hand therapist's guidance and adhere to the prescribed therapy program diligently for the best possible outcomes after flexor and extensor tendon repairs.