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

Immobilisation:

• Protective hand-based splint in intrinsic-plus position.

• Removed for supervised exercises as directed.

Precautions:

• Protect fixation.

• Avoid forceful gripping or resisted finger flexion.

• Avoid weight bearing through the hand.

Therapy:

• Early controlled active finger range of motion within comfort.

• Emphasis on full extension and tendon gliding exercises.

• Adjacent joint mobilisation (wrist and unaffected digits).

• Oedema control and elevation.

Criteria to Progress:

• Wound healing satisfactory.

• Controlled active motion without increased pain or instability.

Phase II: Progressive Motion Phase (2–6 Weeks)

Immobilisation:

• Splint gradually weaned depending on fracture stability and surgeon guidance.

Precautions:

• Avoid heavy gripping and resisted strengthening.

• Avoid rotational stress to the finger.

Therapy:

• Progress active range of motion toward full flexion and extension.

• Continue tendon gliding exercises.

• Light functional hand use as tolerated.

Criteria to Progress:

• Improving range of motion.

• Minimal pain with light activities.

Phase III: Strengthening Phase (6–12 Weeks)

Precautions:

• Avoid sudden high-load gripping if discomfort persists.

Therapy:

• Begin gentle grip and pinch strengthening.

• Progressive functional hand use.

• Dexterity and coordination exercises.

Criteria to Progress:

• Near full, pain-free finger range of motion.

• Radiographic evidence of fracture healing.

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

Therapy:

• Progressive strengthening and endurance training.

• Return to manual work and sports as tolerated.

Criteria to Discharge:

• Strength appropriate for occupational and recreational demands.

• Clearance by the treating surgeon.

General Recommendations

Work:

• Office/desk work may resume immediately if pain is well controlled

• Manual labour should be deferred until 6–8 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 use 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.

• Higher-demand hand use, contact, or impact activities typically from 8–12 weeks or longer with full recovery and surgeon clearance.

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.