Phase I: Early Recovery and Motion (0–2 Weeks)

Immobilisation:

• No splinting required.

Precautions:

• Avoid heavy gripping and forceful repetitive hand activities.

• Avoid sustained weight bearing through the palm.

• Keep wound clean and dry until healed.

Therapy:

• Immediate finger, thumb, and wrist range of motion exercises.

• Gentle tendon gliding exercises.

• Light functional hand use as tolerated.

• Oedema control and elevation.

Criteria to Progress:

• Wound healing satisfactory.

• Pain and swelling controlled.

• Comfortable light hand use.

Phase II: Functional Recovery (2–6 Weeks)

Precautions:

• Gradual return to heavier gripping only as tolerated.

• Avoid prolonged pressure on the palm if tender.

Therapy:

• Progress wrist and hand range of motion to full.

• Begin gentle grip and pinch strengthening.

• Scar management and desensitisation as required.

• Gradual return to daily activities.

Criteria to Progress:

• Improving grip strength.

• Minimal wound tenderness.

• Functional use of the hand in daily activities.

Phase III: Strengthening Phase (6–12 Weeks)

Precautions:

• Avoid sudden high-load gripping if pain persists.

Therapy:

• Progressive grip and pinch strengthening.

• Endurance training for repetitive hand tasks.

• Return to heavier manual activities as tolerated.

Criteria to Progress:

• Good functional strength.

• No significant pain with daily use.

Phase IV: Return to Full Activity (3–6 Months)

Therapy:

• Full return to work and recreational activities as tolerated.

• Ongoing strengthening if required.

Criteria to Discharge:

• Pain-free functional hand use.

• Grip strength appropriate for occupational and recreational demands.

General Recommendations

Work:

• Office/desk work may resume after 1–2 weeks if pain is well controlled

• Manual labour should be deferred until 4–6 weeks depending on job demands

Driving:

• It is important that you are medically fit to return to driving and you feel safe to control the vehicle and take evasive action if needed.

Sports and Leisure:

• Lower-limb activities may resume as comfort allows.

• Light hand and wrist activities may resume as tolerated within the first 1–2 weeks.

• Progressive return to functional and light activities from 2–4 weeks.

• Heavier gripping and lifting from approximately 4–6 weeks as comfort allows.

Disclaimer: This protocol is intended as a general rehabilitation guide only. Rehabilitation progression should always be individualised and may be modified by A/Prof Ernstbrunner and the treating rehabilitation team based on the patient’s clinical progress, surgical findings, and individual circumstances.