Wrist extended 45 degrees, MCP's in 0 to 5 degrees of flexion, interphalangeal joints are free. Active range of motion of the interphalangeal joints is initiated immediately. The patient may be immobilized in a forearm based cast or splint. If the patient is splinted, sutures are generally removed at two weeks and scar massage is initiated.
4 - 6 weeks:
Gentle Active Flexion of the metacarpal phalangeal joints with interphalangeal extension and wrist extension is allowed. At four weeks, the wrist component of the splint is discontinued.
7 - 12 weeks:
Passive range of motion, dynamic splinting and electrical stimulation is instituted for metacarpal phalangeal stiffness and tendon adhesions. Progressive strengthening is started at eight weeks anticipating a return to work at 12 weeks.
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