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Extensor tenolysis and joint release therapy(Usually performed with dorsal capsulectomy or PIP arthroplasty)NOTE: It is essential that the quality of the tendon/s and the Range of Motion achieved in surgery is charted. The following protocol is recommended for tendons which are felt to be in good condition throughout at the end of the tenolysis. Otherwise, the frayed tendon protocol may be more appropriate. 0 - 1 day: A light dressing and edema control with coban on the fingers is applied as needed. A light dressing and edema control is applied as needed. Elevation is emphasized. Active and Passive Range of Motion exercises are initiated two to four times daily. A Safe Position splint is fitted to be worn between exercises and at night. 3 - 5 days: Active and passive range of motion exercises are initiated 15 min/hr. Taping and/or dynamic splinting may be initiated as needed to increase Passive Range of Motion. Functional Electrical Stimulation or Standard Electrical Stimulation may be initiated within 48 hours postoperatively as needed to assist in tendon excursion. 6 weeks: Gentle resistance may be initiated to the extensors using soft putty.
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