The evolution of early mobilization of the repaired flexor tendon.

The most important difference between the various approaches to postoperative digital flexor tendon rehabilitation is how the repaired tendon is treated during the first three to six weeks, in the earliest stages of healing. Early mobilization is the most commonly reported method of managing the healing flexor tendon. There are many different protocols and abundant research to support published approaches to tendon management. With so many choices, today's hand therapist must understand not only what those choices are, but also why and when to use them. There is no one correct way to manage a repaired flexor tendon; the specialist who does not understand how current techniques evolved is ill-equipped to design the appropriate treatment for a given patient. This article presents an overview of management options and how they have been developed over time, with special attention to changes in splint and exercise design in the crucial first few weeks after repair.