I. Within 3 weeks after surgery.
The most important thing is early activity, as early as immediately after recovery from postoperative anesthesia. The greatest difficulties faced by patients at this time are psychological fear (fear of re-rupture) and pain tolerance.
The purpose of strong exercise is twofold.
1, to prevent adhesions.
2. to promote healing.
The later the exercise, the more likely adhesions will occur and the more painful the tendon will be, the more likely it will rupture.
Question 1: Can the tendon move or rupture after suturing?
First of all, the surgeon will use the best sutures (thin and strong sutures, a #2 ethibon non-absorbable suture can lift a small rhinoceros) to connect the tendon, the purpose of the sutures is to connect the severed ends to restore the continuity of the tendon. Therefore, the tendon can withstand a certain amount of tension after surgery, but the force is transmitted through the sutures. However, even if the sutures are strong, they can only withstand a certain load and will break if they are larger; at the same time, the sutures are an elastomer and will become fatigued by repeated pulling, leading to rupture.
Therefore, the correct answer is to follow the correct exercise method so that the tendon can be moved and not ruptured after the surgery.
Question 2: What is the correct way to exercise?
The correct way is to move passively. The ruptured tendon cannot withstand too much tension: for example, after a flexor tendon rupture, it can be actively straightened and passively flexed, while an extensor tendon rupture is actively flexed and passively straightened. The injured muscle can never be actively contracted, i.e., exerted; movement in the opposite direction can be exerted. Some studies have shown that early stretching exercises promote the formation of longitudinal alignment of new collagen fibers, reducing adhesions and promoting healing.
Question 3:: How long and how many times a day should I be active?
The purpose of early tendon activity is to prevent adhesions, so only 1 extreme movement is required per day, with full flexion and full extension; this 1 movement takes a long time course, up to 20 minutes, due to the pain of the postoperative wound. The exercise is followed by rest in the joint rest position to create the conditions for the tendon to heal. The tendon heals without tension, which means that the tendon must heal without tension and in the resting position. The healing time takes roughly 3 weeks for the fibrous scar to heal.
Question 4: Is it better to practice more and more every day for a longer period of time?
The process of exercise is also injury, the more times and the longer the time, the more local inflammation of the tendon, but not conducive to the repair of the tendon. So it is enough to ensure one extreme exercise per day.
Question 5:: What is the role of sutures in the tendon healing process?
In the early stage, before the tendon is healed, the sutures are used to connect the tendon and transmit the force; after the tendon is healed, the sutures no longer play a role.
Second, 4 to 5 weeks after surgery
Instruct the patient to move the affected limb (finger) lightly and actively, with gentle movements and appropriate force, 3 times a day for 5 min each time. Massage the muscles and joints, together with the use of local physical therapy, such as ultra-short wave, spectrum and other therapies. It is equivalent to muscle stretching exercise, which is beneficial to the reconstruction and shaping of muscle fibers.
Third, 6 to 10 weeks after surgery
The functional exercise of impedance is gradually increased in the later period, and the functional activities are progressed gradually from simple to complicated. Encourage the patient to do daily life movements, and strive for complete recovery in 4-8 weeks.