Suture: 4.0 monofilament Kessler with peripheral epitenon suture
Splint: Standard Dorsal Blocking Plaster splint with wrist in full flexion minus 30° (usually 30-40°), Metacarpophalangeal joints at 90° flexion and interphalangeal joints at 0°. More recent modifications of this regime have a less extreme flexion posture.
Early Active Exercises: 2 days post-op, commence 2 hourly exercise sessions with 2 active flexion movements into air (proximal interphalangeal joints to 30° and distal interphalangeal joints to 5-10°), then 2 passive flexion movements into the palm, and 2 active extension movements back into the splint.
The splint is discontinued. The patient is started on active flexion exercises and differential gliding exercises are initiated.
Strengthening and passive extension exercises are instituted as needed. At 12 weeks the patient may return to work and unrestricted activities.
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