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Rehabilitation Following Zone II Flexor Tendon Repairs

Kannas, Stephanie OTR/L, CHT, CLT-LANA*; Jeardeau, Teresa A. OTR/L, CHT*; Bishop, Allen T. MD

Techniques in Hand & Upper Extremity Surgery: March 2015 - Volume 19 - Issue 1 - p 2–10
doi: 10.1097/BTH.0000000000000076

Ongoing clinical and basic research has improved understanding of flexor tendon mechanics and physiology for surgical repair and rehabilitation after a zone II flexor tendon repair. Yet, the ideal surgical repair technique that includes sufficient strength to allow safe immediate active motion of the finger, without excessive repair stiffness, bulk or rough surfaces resulting in excessive resistance to flexion, does not exist. After optimizing the repair, the surgeon and therapist team must select a rehabilitation plan that protects the repair but helps to maintain tendon gliding. There are 3 types of rehabilitation programs for flexor tendon repairs: delayed mobilization, early passive mobilization, or an early active mobilization. No guideline for rehabilitation should be followed exactly. Many factors influence therapy decisions, including repair technique, associated tendon healing, passive versus active range of motion, edema, and tendon adhesions. These factors can assist in guiding rehabilitation progression and promote functional range of motion, safely mobilize the repaired tendon(s) and prevent gapping, rupture, and adhesions.

Divisions of *Physical Medicine and Rehabilitation

Orthopedic Surgery, Mayo Clinic, Rochester, MN

Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding.

Address correspondence and reprint requests to Stephanie Kannas, OTR/L, CHT, CLT-LANA, Division of Physical Medicine and Rehabilitation, Mayo Clinic, 200 First St. SW, Rochester, MN 55905. E-mail:

© 2015 by Lippincott Williams & Wilkins