Finger flexor tendon repair

Transcription

1 Finger flexor tendon repair Alternative protocol Information for patients Hand Therapy

2 Patient's name: Date of surgery: Your therapist is: Statements Complying with the instructions/treatment advice given by your Therapist, and in this booklet, aims to provide you with a good outcome. However, this is not always guaranteed and there is always a risk of complications which affect the overall result. We must seek your consent for any procedure or treatment beforehand. Staff will explain the risks, benefits and alternatives where relevant before they ask for your consent. If you are unsure about any aspect of the procedure or treatment proposed, please do not hesitate to ask for more information. Introduction This booklet has been designed specifically for patients who have had repair of their finger flexor tendon/s. These tendons run from the forearm to the fingers and flex (bend) your fingers into a fist. The repaired tendon is much weaker than normal and will take about 12 weeks to recover full strength. page 2 of 12

3 The information and advice in this booklet is intended to be a guideline and should be followed with the advice given by your therapist and doctor. Taking your painkillers as prescribed will help you to follow your exercise regime. Flexor tendon repair early active movement regime What can I do in the first 4 weeks after my operation? Splinting: The tendon is very weak after your operation and you need to wear a protective splint which will help prevent you from over stretching or breaking the tendon. The splint will be made by your therapist and must be worn all the time for 4 weeks, and at times for 2 weeks after that. Do not remove or alter your splint as this may cause your tendon to break and you will require further surgery. It is important that your splint is comfortable to wear. If any of the following occur contact your therapist as soon as possible: 1. Pins and needles sensation other than that you may already have 2. Pain caused by the splint 3. Any areas of pressure 4. Defects in the splint 5. Any changs in the circulation, for example, changes in colour or temperature of your hand 6. Any increase in swelling page 3 of 12

4 What exercises should I do? The following exercises should be performed every... hours throughout the day: Passive: Push each finger into the palm of your operated hand, using your other hand and hold for 20 seconds. Repeat... times Active: Make a fist with all the fingers together on your operated hand and then straighten all fingers fully until your nails touch the top of the splint. Repeat... times Do not push the fingers straight with the other hand or you could break the tendon. You also need to maintain the movement of uninjured joints (shoulder, elbow and thumb) which are not held in the splint, as advised by your therapist. What should I do if I suddenly loose movement or feel a snap in my operated fingers? You should contact the Hand Unit immediately on: Or attend your local A&E if out-of-hours. page 4 of 12

5 Other important information Keep your hand raised above the level of your heart at all times (except when doing your exercises) to prevent swelling. Do not attempt to clean your hand as you may break the repaired tendon. Do not use the operated hand for any activity at all apart from the stated exercises as your tendon may break. Do not drive any vehicle - your therapist / doctor will advise you when to return to driving. What can I do between 4 to 6 weeks after my operation? Start date: With the advice of your therapist your splint can now be removed at times during the day and for exercise. Remember that your repaired tendon is still very weak and at risk of breaking. What can I do? 1. Wash your hand as advised by your therapist 2. Keep your hand raised if it is still swollen. Your therapist may also advise you to do "contrast bathing". 3. Begin scar massage if your wound is healed, as shown by your therapist using a rich moisturising cream, for example, E45 cream, Nivea or Diprobase. page 5 of 12

6 Please: a. Do not use your operated hand for any activity at all other than your exercises b. Do not push your fingers or wrist back straight with your other hand as these activities may break your tendon. What exercises can I do 4 weeks after my operation? You should do these exercises every... hour/s... times. Fingers Ensure all exercises are done with your wrist straight. 1. Keeping your fingers straight, bend and then straighten the knuckles. 2. Keeping the knuckles straight, bend and straighten the tip and middle joints of the fingers. page 6 of 12

7 3. Make a fist and then straighten the fingers. Wrist Do the exercises as advised by your therapist. With your fingers bent slowly move your wrist forwards and backwards. Passive exercises: Continue at 4 weeks after your operation You should do these exercises every... hour/s... times. 1. Using your other hand, bend the whole finger down into the palm and hold for 20 seconds. page 7 of 12

8 What can I do at 6 weeks after my operation? Start date: 1. Us e your hand for light activities such as: Washing / dressing / brushing your hair Holding cutlery Holding a half pint glass / mug / cup and saucer Writing for short periods of time (about 15 minutes) Typing on a computer / using a remote control vi) Turning pages of a book / newspaper Board games / jigsaws / sewing / knitting 2. Continue with scar massage. What must I not do? Please: 1. Do not lift / carry anything heavier than 1/2 kg / 1lb in weight 2. Do not drive any vehicle 3. Do not grip anything hard, for example, do not squeeze a ball, turn a top or open a car door with your operated hand 4. Do not play any sports What happens at 7 weeks after my operation? Start date: Your tendon is still too weak for heavy tasks as it still may break. 1. Your therapist may make a night extension splint to help straighten your fingers and wrist fully. 2. Your therapist may teach you some extra exercises. page 8 of 12

9 What can I do 8 to 10 weeks after my operation? Start date: You can now do a little more with your hand. 1. Us e your hands for activities such as: Playing snooker / pool / darts / table tennis Playing computer games Light housework, for example, dusting, washing and drying up (do not lift heavy pots and pans), cleaning windows Light decorating, for example, painting 2. Continue with your exercises and scar massage as advised by your therapist. 3. Start to work on gentle gripping exercises, as advised by your therapist. What must I do? Please: 1. Do not lift anything heavy 2. Do not drive any vehicle (unless you have been told otherwise by your therapist or doctor) 3. Do not play any sports (apart from those mentioned above) page 9 of 12

10 What can I do at 10 weeks after my operation? Your tendon is almost fully healed, but you need to avoid heavy work / heavy lifting for a further two weeks. 1. Most activities around the home, avoiding heavy lifting. 2. Return to driving with the advice of your therapist / doctor (you will need to inform your insurance company). 3. Continue with your exercises and massage as advised. What must I not do? Please: 1. Do not lift any heavy weight 2. Do not play any sports (except for those previously mentioned, for example, snooker, pool, darts, table tennis). What happens at 12 weeks after my operation? Start date: Your tendon should be fully healed and strong enough for you to begin heavy lifting and gradually return to full activities including sports and heavy manual work. Your hand will feel weak but do not worry, your strength will build up gradually with increased use. page 10 of 12

11 page 11 of 12

12 If you have any problems or questions regarding your hand please telephone: or and leave a message for your therapist. Produced with support from Sheffield Hospitals Charity Working together we can help local patients feel even better To donate visit Registered Charity No Alternative formats can be available on request. Please alternativeformats@sth.nhs.uk Sheffield Teaching Hospitals NHS Foundation Trust 2017 Re-use of all or any part of this document is governed by copyright and the Re-use of Public Sector Information Regulations 2005 SI 2005 No Information on re-use can be obtained from the Information Governance Department, Sheffield Teaching Hospitals. infogov@sth.nhs.uk PD7618-PIL3111 v3 Issue Date: December Review Date: December 2019