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Anatomical illustration showing thumb extensor tendon
Thumb extensor tendon repair

Advice and exercises following your thumb extensor tendon repair

This resource has been written to provide you with information following surgery to repair your thumb extensor tendon. A cut into this tendon, 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 enable 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/s has been repaired to restore this 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

Photograph of hand and lower arm with a splint attached that covers the thumb and forearm.
Splint

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

The repair will be weak and will require protection in a splint to prevent movements and activity that will risk rupturing your tendon. You should wear the 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 (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

1. Move your thumb upwards away from the splint with your other hand. J7A3285-Edit

2. Actively move your thumb upwards away from the splint. J7A3286-Edit

3. Actively move your thumb upwards away from the splint and bend the top of your thumb. J7A3288-Edit 

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.

Perform 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 for example:

• 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:

• Carrying a cup of tea or plate of food.

• Pull-up jeans/trousers/shorts.

• Opening doors.

• Driving.

5–7 Weeks After Surgery

You can stop wearing the splint during the day. Your therapist will advise you if you need to continue to wear the splint when you go to bed.

Exercises

You should complete the following exercises:

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

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 – Edit

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. Touch each fingertip with your thumb. J7A3292 – Edit

Photograph of elbow resting on a table the hand is raised and shows fingertip of third finger touching tip of thumb
Finger touching tip of thumb

4. Bend your thumb across your palm towards the base of your little finger. J7A3294 – Edit

Exercise shows hand raised with thumb bending across palm towards the base of little finger
thumb bent across palm towards base of little finger
Day To Day Dos and Don’ts

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.
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 thumb.
  • 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

Monday to Friday 8.00am – 5.00pm

or

The Hand Therapy Team on 01274 382874

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.

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