2 Weeks Post Op

• Therapist will assist with edema control, possibly with electrical stimulation, ultrasound, moist heat, or ice pack. 
• Follow up appointment for splint and/or suture removal
• Use of removable splint as needed to support the wrist for pain control (removable splint does not have to be worn if the patient is comfortable)
• Encourage full finger ROM. Patient should be able to form a fist. Goal is to achieve full finger ROM by 2-3 weeks post op
• Passive and active-assisted ROM can be performed to encourage full finger ROM
• Initiate active and GENTLE passive ROM to wrist (Composite wrist/digit extension/flexion should be avoided to prevent stretching of extrinsic muscles.)

6-8 Weeks Post Op

• Weighted wrist stretches initiated to regain passive ROM to wrist
• Begin isometric strengthening exercises
• Forceful manipulation and joint mobilization are NOT appropriate
• Neoprene wrist wrap may be worn for comfort

8-12 Weeks Post Op

• Removable splint may be discontinued and worn only as needed
• Gentle strengthening exercises initiated with putty, hand exerciser, or hand weights, followed by job simulations

4-6 Months Post Op

• Most patients should be back to work after 2-3 months
• Heavy labor jobs may require up to 6 months.  Follow up with doctor on a PRN basis.
• Considerations: Expect some weakness; grip and strength averages about 50-80% of the contra-lateral side. Usually it takes up to a year to regain best strength. Expect ~50% of wrist flexion and/or extension loss. Attempting to achieve full wrist ROM can create instability and ultimately increase risk of future wrist pathology.

Note: These instructions are to serve as guidelines and are subject to Physician discretion.  Actual progress may be faster or slower depending on the individual