Rehabilitation of flexor and extensor tendon injuries in the hand: current updates

Injury. 2013 Mar;44(3):397-402. doi: 10.1016/j.injury.2013.01.022. Epub 2013 Jan 21.


In recent years, a significant amount of research in the field of tendon injury in the hand has contributed to advances in both surgical and rehabilitation techniques. The introduction of early motion has improved tendon healing, reduced complications, and enhanced final outcomes. There is overwhelming evidence to show that carefully devised rehabilitation programs are critical to achieving favourable outcomes. Whatever the type, or level, of flexor or extensor injury, the ultimate goal of both the surgeon and therapist is to protect the repair, modify peritendinous adhesions, promote optimal tendon excursion and preserve joint motion. Early tendon motion regimens are initiated at surgery or within 5 days post repair. Intra-operative information from the surgeon to the therapist is vital to the choice of splint protected position to reduce repair rupture/gap forces, and to commencement of active, or splint controlled, motion for tendon excursion. Decisions should align with the phases of healing, the clinician's observations, frequent range of motion measurements and patient input. Clinical concepts pertinent to early motion rehabilitation decisions are presented by zone of injury for both flexor and extensor tendons during the early phases of healing.

Publication types

  • Review

MeSH terms

  • Decision Making
  • Finger Injuries / physiopathology
  • Finger Injuries / rehabilitation
  • Finger Injuries / surgery*
  • Hand Injuries / physiopathology
  • Hand Injuries / rehabilitation
  • Hand Injuries / surgery*
  • Humans
  • Interdisciplinary Communication
  • Orthopedic Procedures*
  • Outcome Assessment, Health Care
  • Postoperative Care*
  • Postoperative Complications / prevention & control*
  • Range of Motion, Articular
  • Splints / statistics & numerical data
  • Suture Techniques
  • Tendon Injuries / physiopathology
  • Tendon Injuries / rehabilitation
  • Tendon Injuries / surgery*
  • Tissue Adhesions
  • Wound Healing*