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

Immobilisation:

• No splinting required.

Precautions:

• Avoid forceful gripping and repetitive hand activities in the early postoperative period.

• Avoid prolonged pressure over the incision site.

• Keep wound clean and dry until healed.

Therapy:

• Immediate active finger and thumb range of motion.

• Encourage full flexion and extension several times daily to prevent stiffness.

• Light functional hand use as tolerated.

• Oedema control and elevation.

Criteria to Progress:

• Wound healing satisfactory.

• Full active finger/thumb extension.

• Comfortable light hand use.

Phase II: Functional Recovery (2–6 Weeks)

Precautions:

• Gradual return to stronger gripping as tolerated.

• Avoid heavy manual tasks if incision remains tender.

Therapy:

• Maintain full finger and thumb range of motion.

• Begin gentle grip and pinch strengthening.

• Scar management and desensitisation if required.

• Progressive return to daily activities.

Criteria to Progress:

• Minimal scar tenderness.

• Full pain-free range of motion.

• Improving grip strength.

Phase III: Strengthening Phase (6–12 Weeks)

Precautions:

• Avoid sudden high-load gripping if discomfort persists.

Therapy:

• Progressive strengthening for grip and pinch.

• Endurance training for repetitive tasks.

• Return to manual work and higher-demand activities as tolerated.

Criteria to Progress:

• Functional strength appropriate for daily activities.

• No triggering or locking symptoms.

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

Therapy:

• Full return to occupational and recreational activities as tolerated.

• Ongoing strengthening if required.

Criteria to Discharge:

• Pain-free finger/thumb motion.

• No recurrence of triggering.

• Strength appropriate for occupational and recreational demands.

General Recommendations

Work:

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

• Manual labour should be deferred until 2–4 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.

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.