Rehabilitation of flexor tendon injuries
Zoning of the flexor tendon
Zone I: Includes the tip of the finger, the distal phalangeal joint, and the distal half between the distal phalangeal joint and the proximal phalangeal joint.
Zone II: including the distal phalangeal joint and the proximal half of the interproximal phalangeal joint, and the proximal phalangeal joint to the transverse palmar line.
Zone III: Includes the area from the transverse palmar line to the distal end point of the thumb accessing the palm.
Zone Ⅳ: the distal end point of the thumb accessing the palm to the transverse wrist line.
Zone V: from the transverse wrist stripe to the forearm.
Rehabilitative treatment methods
Good hand function is based on the biomechanical balance of the extensor, flexor and intrinsic muscles, and injury to any one tendon can affect this balance. Because tendon adhesions are particularly likely to occur during the repair of tendon injuries, early activity is emphasized in the rehabilitation of tendon injuries.
Rehabilitation activity procedures after flexor tendon repair
Remove the plaster rest (the power device of the splint) from the fourth to the sixth postoperative week and allow the patient to perform the following training activities.
(1) Light active flexion of the wrist and fingers;
② Active extension of the metacarpophalangeal and interphalangeal joints;
(3) Continuous and extensive passive flexion of the wrist and fingers;
④Continuous, careful passive extension of the interphalangeal joints with the metacarpophalangeal joints fully flexed;
⑤ Start to loosen the wrist joint, but be careful to keep the fingers flexed when extending the wrist; when extending the fingers, keep the wrist flexed and not extend both at the same time. In between exercises and at night, you need to continue to wear a cast brace to ensure safety.
Rehabilitation activity program after flexor tendon repair
Training activities in the seventh week postoperatively include.
①Active flexion and extension of the wrist and fingers;
②Passive flexion of the wrist and fingers with force;
③Sliding exercises of the superficial flexor tendon alone;
④Sliding exercises for deep flexor tendons of individual fingers;
⑤Hooking exercise: put the hand into a duckbill shape, maximize the flexion of the proximal and distal finger joints while straightening the metacarpophalangeal joints, and then return the hand to the duckbill shape and repeat several times;
(6) Fist clenching exercise: grasp and release the fist with maximum force.
Rehabilitation activity procedures after flexor tendon repair
Training activities in the eighth postoperative week include.
(1) Active light resistance flexion hand activities, such as grasping and squeezing sponge balls or cotton balls.
(2) Active resistive stretching activities, such as propping the fingers through a rubber band, etc.
(3) Hard passive flexion of the hand.
Rehabilitation activity program after flexor tendon repair
Training activities in the ninth postoperative week include.
(1) Active heavy resistance flexion of the hand, such as grasping and squeezing playdough of different strengths.
(2) Active heavy resistance stretching activities, such as holding the fingers apart with multiple rubber bands, etc.
(3) Passive flexion and extension of the hand with force.
(4) Freehand or mechanical distraction therapy for those with flexion contractures.
Rehabilitation activity procedures after flexor tendon repair
Training activities in the tenth postoperative week include.
(1) Passive distraction of the wrist and all joints of the fingers.
(2) Functional strengthening hand work activities, such as making dough, scrubbing clothes, screwing different types of screws, etc.