Therapy Guide

  • Commonly for RA to reduce pain and improve ROM & function
  • Dorsal longitudinal incision
  • Bulky dressing with POP backslab
  • Elevation of hand and arm for 2 weeks
  • Early hand and wrist ROM exercises
  • POP backslab removed at 3 days and replaced with thermoplastic forearm-based extension splint.  To wear at night and for comfort for 6 weeks
  • No active triceps for 6 weeks

Exercises – To be done every hour

  • Full fist to fully straight hand x10
  • Wrist up and down x20
  • Active elbow flexion with passive extension (i.e., eccentric biceps) x10
  • Sustained elbow flexion with overpressure using other hand x3 mins
  • Sustained elbow extension with overpressure using other hand x3 mins
  • Supination with elbow at 90° tucked into side
  • Scar massage x 5 minutes once wound has healed
  • Use weight to help stretch into extension and hold up to 5 minutes

Look out for

  • Inability to actively straighten arm (triceps may have pulled off)
  • If poor ROM then contact Hand Therapy at the RUH – may come in for intensive Physio
  • Infection – send to GP urgently for antibiotics and refer back to next clinic
  • Numbness or wrist drop.  Can be radial or ulnar nerve disruption.

The Hand to Elbow Clinic
29a James Street West
Bath BA1 2BT

Tel 01225 316895
Fax 01225 484949
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