What is the recommended splinting approach for early AROM after flexor tendon repair?

What is the recommended splinting approach for early AROM after flexor tendon repair?

• A. Volar plate splint
• B. Short arm cast
• C. Use dorsal block for most of the time, then a separate orthosis with wrist extension for gentle active flexion
• D. No splint

Answer: (C)

Early controlled motion after flexor tendon repair relies on protecting the repair while encouraging tendon glide. Using a dorsal block splint most of the time achieves that by immobilizing the MCP joints in flexion, which prevents extension at the repair site and thus minimizes tensile load during active attempts at finger movement. At the same time, it allows movement at the IP joints, promoting glide and reducing adhesions as healing begins. As healing progresses, switching to a separate orthosis with the wrist in extension further supports gentle active flexion. Placing the wrist in extension changes the length-tension relationship of the forearm flexors, enabling the patient to perform controlled flexion with less strain on the repaired tendon while continuing to protect it. This staged progression—initial protection with a dorsal block, followed by a wrist-extended orthosis for gradual active flexion—offers safe, incremental loading that supports both repair integrity and functional ROM.

Early controlled motion after flexor tendon repair relies on protecting the repair while encouraging tendon glide. Using a dorsal block splint most of the time achieves that by immobilizing the MCP joints in flexion, which prevents extension at the repair site and thus minimizes tensile load during active attempts at finger movement. At the same time, it allows movement at the IP joints, promoting glide and reducing adhesions as healing begins.

As healing progresses, switching to a separate orthosis with the wrist in extension further supports gentle active flexion. Placing the wrist in extension changes the length-tension relationship of the forearm flexors, enabling the patient to perform controlled flexion with less strain on the repaired tendon while continuing to protect it. This staged progression—initial protection with a dorsal block, followed by a wrist-extended orthosis for gradual active flexion—offers safe, incremental loading that supports both repair integrity and functional ROM.