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Advice and exercises following your digital nerve repair

This leaflet has been written to provide you with information following your surgery to repair your extensor tendons. A cut in these tendons, even if only part way through, is a serious injury. It is important that you follow the advice of your hand surgeon, therapist and this leaflet to achieve the best possible outcome.
What Are Your Extensor Tendons?

Extensor tendons allow you to straighten your fingers and thumb. They run from muscles in the back of your forearm into the hand where they attach to the bones of your fingers and thumb. They are important in allowing you to open your hand during activity and are essential in allowing your hand to function normally.

Why have these been repaired?

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

Swelling

It is normal to have swelling in your hand after an injury or surgery. To help drainage of this swelling whenever possible:

Do rest your hand above the level of your heart. Use a cushion to support your arm if this is comfortable.

Do move your elbow, shoulder and neck regularly to prevent stiffness in these joints.

Do not allow your hand to hang by your side.

Early movement of your fingers as described in this leaflet will help to manage your swelling and prevent stiffness later.

0–5 Weeks after surgery

Splints J7A3270

Picture of hand and lower arm held out from body in a splint
Hand and lower arm in a splint

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 the splints 24 hours a day.

While wearing your splints 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 (please do not remove your splint).

Do 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.

Exercises

You will not stop your tendon healing by moving your thumb and fingers. Bending and straightening your fingers will help regain movement and reduce swelling.  You should complete the following exercises wearing your splint:

1. With your other hand lift your fingers up away from the splint. J7A3271

Picture shows other hand lifting fingers up and away from the splint.
hand lifting fingers away from splint.

2. Actively straighten your fingers away from the splint. J7A3273.

Picture shows how to actively straighten your fingers away from the splint
Straighten fingers away from splint

3. Actively straighten your fingers away from the splint then curl your fingers. J7A3274

Actively straighten your fingers away from the splint then curl your fingers
Curl your fingers
Scar Massage

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

Use a simple moisturiser such as E45, Nivea or aqueous cream. Massage the cream over the scar in circular movements.

Try to do this 3-4 times a day for 5 minutes.

Day to Day Dos and Don’ts

Dos

You can use your hand for light activities, such as:

• Doing up buttons/shoelaces.

• Dressing with light clothes.

• Holding paper.

• Using a mobile phone.

Don'ts

You must not use your injured hand for heavier activities, such as:

• Carrying a cup of tea or plate of food.

• Pulling up your jeans/trousers/shorts.

• Opening doors.

• Driving.

5 Weeks After Surgery

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 is not fully strong until 10 –12 weeks after surgery. You are at risk of rupturing your tendon and needing further surgery if you do not follow this advice.

Exercises

You should complete the following exercises without your wrist splint:

1. Support your forearm on the table. Bend your wrist downwards relaxing your fingers. J7A3257

Exercise shows forearm supported on a table with hand raised and wrist bent downwards.
Forearm supported on table with hand raised and wrist bent downwards.

2. Support your forearm on the table. Bend your wrist upwards. J7A3258

Exercise shows forearm supported on a table with hand raised and wrist bent upwards.
Forearm supported on table with hand raised and wrist bent upwards

3. Rest your elbow on the table. Straighten your fingers. J7A3259

Picture shows elbow resting on a table, hand raised with straight fingers
Hand raised with straight fingers

4. Rest your elbow on the table.  Bend your fingers at the knuckles whilst keeping your finger joints straight. J7A2048

Elbow resting on a table, fingers bent at the knuckles, finger joints straight
Fingers bent at the knuckles, finger joints straight

5. Rest your elbow on the table, curl and open your fingers without making a full fist. J7A3260

Picture shows elbow resting on a table, arm raised, hand curled and fingers open without making a full fist.
Fingers curled, hand open without making a full fist

6. Rest your elbow on the table. Close your hand to make a full fist. J7A3268

Picture shows elbow resting on a table with arm raised and hand closed to make a full fist
Elbow rests on table with hand raised in full fist
Day To Day Dos and Don’ts

Dos

You can use your hand for medium heavy activities, such as: 

  • Carrying a cup of tea or plate of food.
  • Pulling up jeans/trousers/shorts
  • Opening doors.
  • Driving if safe.
  • Cycling.

Don'ts

You must not use your injured hand for heavier activities until you are 12 weeks following repair:

  • Contact sports
  • Heavy lifting/labour
Important Information

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.
  • You still have an open wound and are concerned that you have a wound infection. Signs of infection are:
    • increased redness around the wound
    • redness spreading down your forearm
    • throbbing, increased swelling
    • a fever
    • discharge from the wound that is foul smelling or coloured
  • 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.
Contact Details

Plastics clinic on: 01274 364397

Available: Monday to Friday 8.00am – 5.00pm

or

The Hand Therapy Team on: 01274 382874

Available: Monday to Thursday 8.00am – 6.00pm, Friday 8.00am – 3.30pm

Accessible Information

If you need this information in another format or language and are in the hospital, please ask a member of staff. If you are accessing this leaflet online or on your phone you can see our Google Translate automated guidance on the Digital Patient Information Hub home screen.

People with hearing and speech difficulties

You can contact us using the Relay UK app. Textphone users will need to dial 18001 ahead of the number to be contacted.

Smoking

Bradford Teaching Hospitals NHS Foundation Trust is a smoke-free organisation. You are not permitted to smoke or in use e-cigarettes in any of the hospital buildings or grounds.

Published by
, , Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ.

Date of publication: Aug 2025
Review Date: Aug 2028
MID Ref: 25081313