Hand Therapy – Extensor Pollicis Longus (EPL) Repair Zone 1-2

What is an Extensor Pollicis Longus (EPL) Tendon?

The Extensor Pollicis Longus (EPL) runs from the muscle in the forearm into the hand where they are attached to the bones of your thumb. This tendon enables you to straighten your thumb.

What is an Extensor Pollicis Longus Tendon Repair?

This is surgery to repair the extensor tendon in your thumb.

Due to injury you have had surgery to repair the extensor tendon which moves your thumb. A cut to this tendon is a serious injury and after it has been repaired will require regular hand therapy to help you regain movement.

This is because your tendon will be very weak after being repaired therefore, it can break easily. Your hand will require care and attention for the next 3 months. This will allow the tendon to heal and regain strength without the risk of it breaking.

What can I expect after surgery?

You will have:

• A large bandage which you MUST NOT remove.

• Swelling around the area of injury. This is normal and should reduce over time. Elevating your hand above your heart can reduce this.

• Pain can be normal immediately after surgery. Please discuss this with your Hand Therapist.

• An appointment with the Hand Therapy Team within 1 week after your surgery.

How do I care for my wound?

Please do not remove any dressing yourself. Your Hand Therapist will assess, check and change your dressing at each appointment.

The wound on your hand may now be bigger than the original cut as to allow the Surgeon to fully inspect and repair the damage. Care has to be taken in order to minimise the risk of infection and this can be helped by keeping the dressing clean and dry.

You will have special stitches in the tendon as well as stitches in the skin. Stitches in the skin are either:

• dissolvable which dissolves in 2 to 3 weeks,

OR

• removable and will be taken out by your Hand Therapist 10 to 14 days after your operation.

Once your dressing is removed by your Hand Therapist, it is very important that you check your wound for signs of infection for example, redness, swelling, oozing, and/or odour. If you have any of the above symptoms please contact the department, your GP or the Urgent Care Centre as soon as possible.

What exercises can I do?

After your operation you will follow a strict rehabilitation programme for 12 weeks. At your first appointment with your Hand Therapist you will be given specific exercises that should be completed regularly.

Please do not try your own exercises as this could cause damage to the tendon.

How should I care for my splint?

You will be provided with a plastic splint in order to protect your tendon repair. Your Hand Therapist will make you a splint to wear on your injured hand, which stops your thumb bending.

It must be worn continuously for 6 weeks; you must not use your injured hand while wearing the splint.

You should:

• Keep the splint clean and dry – cover in a plastic bag for showering/bathing.

• Keep away from sources of heat.

• Clean the outside with baby wipes or a damp cloth.

You should not:

• Remove the splint.

• Try to make alterations to your splint.

Please be aware wearing a splint continuously can cause irritation of the skin on your hand. You may notice some rubbing or digging in. If this becomes red, dry or blistered please contact your Hand Therapist. Please bring your splint to each hand therapy session.

How should I care for my scar?

Your Hand Therapist will show you and advise you when to start scar massage. This is normally once the wound has healed and is scabbed over.

Scar massage is useful as it helps to breakdown the scar tissue. This allows the scar to move more freely and reduces the risk of the scar becoming sensitive.

To complete scar massage you should:

• Apply firm pressure in circular movements along the length of the scar.

• Use non-perfumed cream.

• Complete for 5 minutes at a time at least 4 times a day.

When can I return to my normal activities?

Your repaired tendon is weak for approximately 12 weeks after the operation and care has to be taken to protect it. Your Hand Therapist will guide you through each stage of the healing process.

The table below gives you some examples of timescales and activities.

Do I need to take time off work?

Your Hand Therapist will discuss with you when it is appropriate to return back to your normal work and hobbies. Please speak to your GP, if you need a sick note. The table below gives you a guide of when you may expect to return to work. This will depend on the type of work or activity you do.

Contact Details

Please contact Hand Therapy if:

• You have any concerns or questions.

• If your splint is rubbing or is uncomfortable.

Contact details are:

North Tees and Hartlepool NHS Foundation Trust

Hand Therapy Team

Telephone: 01429 522 471

Monday to Friday, 08:30 a.m. to 04:30 p.m.

You will be asked to attend either:

Hand Therapy

First Floor, North Wing

University Hospital of North Tees

Hardwick Road

Stockton-On-Tees

TS19 8PE

OR

Physiotherapy Outpatients Department

Ground Floor

University Hospital of Hartlepool

Holdforth Road

Hartlepool

TS24 9AH

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Team is here to try to resolve your concerns. The office is based at the University Hospital of North Tees if you wish to discuss concerns in person. Our contact details are:

Telephone: 01642 624719
Freephone: 0800 092 0084
Opening hours: Monday to Friday, 9:30am to 4:00pm
Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.
Telephone: 01642 617617

Patient, Public and People with Lived Experience

We are looking for patients to share their experiences of healthcare and to join our Involvement Bank. Working with the patients, carers, families and the general population we support in making decisions about their care can lead to better health outcomes, increased patient satisfaction and a better overall experience. We want to listen and work with you in shaping the future of your healthcare services. To find out more about the Involvement Bank go to our website or contact us at:

Website: www.nth.nhs.uk/about/community/people-with-lived-experience
Email: [email protected]

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team at:

Email: [email protected]