Flexor tendons allow you to bend your fingers and thumb. They run from your forearm through your wrist and across the palm of your hand. They are important in allowing you to make a fist and are essential in allowing your hand to function normally.

Your tendon has been repaired to restore normal movement. You will need to undergo a strict hand therapy programme following your surgery to maximise your recovery and functional use of your hand.

It is normal to have swelling in your hand after an injury or surgery. Early movement of your fingers as described in this leaflet will help to manage your swelling and prevent stiffness later.

You must not allow your hand to hang by your side. To help drainage of the swelling whenever possible:

• Rest your hand above the level of your heart. Use a cushion to support your arm if this is comfortable.
• Move your elbow, shoulder and neck regularly to prevent stiffness in these joints.

Splints – 12) 815A8623

Within the first week following your repair you will be seen by the hand therapy team. A splint that covers your hand and forearm will be made to protect your surgical repair.

The repair will be weak and will require protection in a splint to prevent movement and activity that will risk rupturing your tendon. You should wear your splint 24 hours a day.

While wearing your splint you will need to check your skin on a regular basis for red or sore areas and inform your therapist if you have any concerns.

Your arm and splint will need to be covered with a plastic bag when showering or bathing. It is important that you do not remove your splint. It is important to keep your wound dry until fully healed.

You must not place your splint in hot water or near a heater as this will affect its shape/fitting and result in the splint becoming uncomfortable to wear

Moving your thumb and fingers will not stop your tendon healing. Bending and straightening your fingers will help regain movement and reduce swelling.

You should complete the following exercises wearing your splint:

1. Use your other hand to bend the operated thumb into the palm of your hand – 16)815A8633

2. Try to flex your thumb away from the splint into the palm of your hand.14)815A8626

3. Support below the end joint then actively bend the end of your thumb, then fully straighten. 17)815A8634

Massage helps make your scar more mobile, so it does not limit movement of your fingers. Once the stitches are removed (unless dissolvable), and your wound looks dry, you can start to massage your scar.

Use a simple moisturising cream such as aqueous or diprobase.

Massage the cream over your scar in circular movements. As your scar matures you can use firmer pressure over your scar.

This will be demonstrated by your therapist, and you should aim to do this 3-4 times a day for 5 minutes.

Do not use your hand for anything other than your exercises unless advised to do so by your therapist.

You can stop wearing your splint, but you should continue to avoid heavy activities until 10 weeks after your surgery. Your therapist will advise you when you can gradually resume heavier activities. The tendon repair will not be fully strong until 10-12 weeks after your surgery. You are at risk of rupturing your tendon and needing further surgery if you do not follow this advice.

You should complete the following exercises without your splint:

1. Support your forearm on a table. Bend your wrist downwards and relax your fingers. J7A3257-Edit

2. Support your forearm on a table. Bend your wrist upwards. J7A3258-Edit

3. Bend the thumb across your palm towards the base of your little finger. J7A3294-Edit

4. Touch your thumb to each fingertip. J7A3292-Edit

5. Bend and straighten the end of your thumb. 21) 815A8646-Edit

Your hand therapist will be able to advise you, but most people are able to resume:

• light activities such as using a keyboard, writing and dressing between 6 and 8 weeks
• driving a car or motorbike when they feel safe to do so and have enough movement and grip. This is usually at 6-8 weeks after surgery
• medium activities such a light lifting, opening doors, carrying plates of food after 8 weeks
• heavy activities such as heavy lifting or building work between 10 and 12 weeks
• sporting activities between 10 and 12 weeks

Do not complete any activity that causes pain. Your tendon is not 100% strong until 12 weeks after repair.

Contact the plastics clinic or therapy department immediately if:

• You are suddenly unable to straighten your fingers
• Your hand or fingers become more swollen, reddened, or blistered
• Your splint becomes uncomfortable or is showing signs of rubbing or irritation such as redness
• You still have an open wound and are concerned that you have a wound infection. Signs of infection are:
  • increased redness around the wound spreading down your arm
  • pain, throbbing or increased swelling
  • a fever
  • discharge from the wound that is foul smelling or coloured