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.

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.

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.

Splints

Within the first week following your repair you will be seen by the hand therapy team. A small “yoke” splint will be made and a separate wrist splint given 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 splints).

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.

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 both splints:

1. Actively bend your fingers into a fist. J7A3229-Edit

2. Actively straighten your fingers. J7A3228-Edit

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.

Perform this 3-4 times a day for 5 minutes.

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.

You can stop wearing the wrist splint during the day but you should continue to wear the yoke splint 24 hours a day and continue to wear both splints for heavier activities.

Exercises

You should complete the following exercises without the wrist splint:

1. Support your forearm on the table. Bend your wrist downwards relaxing your fingers. J7A3237 - Edit

2. Support your forearm on the table. Bend your wrist upwards. J7A3238 – Edit

3. Rest your elbow on the table. Bend your fingers into a fist. J7A3241 – Edit

4. Rest your elbow on the table. Straighten your fingers. J7A3239 – Edit

You can now stop wearing both splints for light activities. The “yoke” splint should continue to be worn for heavy activities. The finger/wrist exercises are continued until full movement is reached by day 49 (7 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 your 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 a table. Bend your wrist downwards relaxing your fingers. J7A3257 – Edit

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

3. Rest your elbow on a table. Straighten your fingers. J7A3259 – Edit

4. Rest your elbow on a table.  Bend your fingers at your knuckles whilst keeping your finger joints straight.J7A3248 – Edit

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

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

Dos

You can use your hand for medium heavy activities for example: 

• 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:

• Heavy lifting/labour.
• Contact sports.

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 finger(s).
• 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.