Hand Therapy – Short Extensor Tendon Repair of the Thumb

(Extensor pollicis brevis and abductor pollicis longus, intact extensor pollicis longus)

What is an extensor tendon repair?

The extensor tendons runs from the muscle in the forearm into the hand where they attach to the bones and joints of your thumb. It is the extensor tendons which enable you to straighten 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 will require regular Hand Therapy to help you regain movement. This is because your tendon will be very weak after being repaired and can break easily.

Your hand will require care and attention to heal back to full strength, without risk of the tendon breaking.

What can I expect after extensor tendon repair?

• After surgery, a large bandage will be placed around your thumb and palm of your hand (do 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.
• To have an appointment in Hand Therapy within one week. On your initial appointment the Hand Therapist will remove your bandage, check your wound and will make you a protective splint to wear on your thumb and forearm.

How do I care for my wound?

Please do not remove any dressings yourself. Your Hand Therapist will assess 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 stitches in the tendon as well as stitches in the skin. Stitches in the skin are either dissolvable in 2-3 weeks, or removable. Your Hand Therapist, between 10 and 14 days after your operation, will take out removable stitches. You will be informed by your Hand Therapist, what type of stiches you have on your initial appointment. It is very important that you monitor your wound for signs of infection (redness of the skin around your dressing, increasing pain and swelling around the affected area, pus oozing through your dressings, fowl smelling odour from your wound and generally feeling unwell). If you think you are developing an infection, contact the Hand Therapy Department, G.P. or Urgent Care Centre as soon as possible if you notice these symptoms

How do I care for my scar?

The Hand Therapist will demonstrate and advise you when to start scar massage. This is normally once the wound has fully healed. Scar massage is useful as it helps to breakdown the scar tissue. This allows the scar and tendon to move more freely and reduces the risk of the scar becoming sensitive.

To complete scar massage

• 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.

How do I care for my splint?

You will be provided with a plastic splint in order to protect your tendon repair. The Hand Therapist will make you a splint to wear on your injured hand and forearm, which stops your thumb from bending. It must be worn continuously for 4 weeks, you must not use your injured hand whilst wearing the splint. 

• DO NOT remove the splint
• Keep the splint clean and dry – cover in a plastic bag for showering / bathing.
• DO NOT try to make alterations to your splint
• Keep your splint away from sources of heat
• You may clean the outside of your splint with baby wipes / a damp cloth.

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.

What exercises can I do?

After your operation, you will need to follow a strict rehabilitation programme for 12 weeks. At your first appointment with the 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

When can I return to normal activities?

Your repaired tendon is weak for approximately twelve weeks after the operation and care has to be taken to protect it. Your Hand Therapist will explain when you can return to normal activities. The following table gives you some examples, which will guide you.

Do I need to take time off work?

Yes. Your Hand Therapist will discuss with you when it is appropriate to return to your normal work and hobbies. Please speak to your G.P, if you require a sick note. The table below details when you may expect to return.

Contact details:

Please contact Hand Therapy if you have any concerns or questions, or if your splint is rubbing or is uncomfortable.

Telephone: 01429 522471 Monday-Friday (08:30-05:00)

North Tees Hospital – 1^st Floor, Hand Therapy, North Wing.

Hartlepool Hospital – Ground Floor, Physiotherapy Outpatients Department

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 Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

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

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, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]