While the patient is in bed, use pillows to keep the hand elevated above the level of the heart to reduce swelling.
A removable splint may be applied at the end of the operation, with the hand
in an intrinsic plus position (“safe” or “Edinburgh” position).
Immobilize the hand in a safe position for at least 3 weeks.
Resting splint after 3 weeks
After 3 weeks, a resting splint is applied, fixing the wrist in 30 degrees
of flexion, the MCP joint in 70-90 degrees of flexion, and with the PIP joint
Every 2-3 hours, passive flexion of the PIP and the DIP is recommended in order to avoid tendon adhesion, according to the Duran method for rehabilitation of flexor tendon lacerations.
Another option is the synergistic splint with a hinge.
See patient 5 days after surgery to check the wound, clean and change the dressing. After 10 days, remove the sutures. Check x-rays.
The fixation will be vulnerable for the first 3 weeks.
After 3 weeks remove the splint and apply buddy strapping. Then begin with active motion exercises.
Instruct the patient to lift the hand regularly overhead, in order to mobilize the shoulder and elbow joints.
The implants may need to be removed in cases of soft-tissue irritation.
In case of joint stiffness, or tendon adhesion’s restricting finger movement, tenolysis, or arthrolysis become necessary. In these circumstances, take the opportunity to remove the implants.