The postoperative dressing is removed.
A Gutter splint holding the digit in full extension is fitted to wear between exercise sessions and at night. (NOTE: active full extension Resting Pan may be used if multiple digits are replaced).
Active and Passive Range of Motion exercises are initiated 4 times a day for 10 - 15 min. The patient is cautioned against lateral stress to the digit.
If there is any lateral deviation of the digit a Bowling Alley splint may be used to control the motion at that joint.
Taping or dynamic flexion may be initiated if passive flexion is less than 70 degrees and there is an extensor lag is less than 30 degrees.
Gentle progressive strengthening may be initiated using foam and putty.
The patient should gradually be weaned off the Gutter splint.
NOTE: An average total Range of Motion of the digit is 60-70 degrees.
With erosive osteoarthritis joints become more easily swollen and inflamed. It may therefore be necessary to be less aggressive with the rehabilitation program.
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