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PNA RESEARCH CASE LIBRARYHand & Upper Limb Rehabilitation · 2025

Orthopedic Rehabilitation Following Complex Repair of the Flexor and Extensor Tendons, Artery, and Nerve: A Case Report

Aydan Novruzova

Cureus · 2025 · DOI: 10.7759/cureus.99643

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THE CASE IN PLAIN ENGLISH

What happened?

A 38-year-old right-hand-dominant woman sustained a glass laceration to the dominant hand, injuring flexor and extensor tendons in the second and third digits, the radial artery and the median nerve. Surgical repair was followed by a staged rehabilitation programme.

Clinical findings

  • Loss of finger flexion and extension, absent radial artery pulse before repair, median-nerve sensory changes and hand oedema.
  • The hand was protected in a custom static wrist-hand splint after tendon, arterial and nerve repair.
  • Range of motion and grip strength were assessed serially over 12 weeks.

Rehabilitation described in the report

  • Weeks 0–3 emphasised splint protection, passive flexion, protected active extension and oedema control.
  • Weeks 3–6 progressed to controlled active flexion-extension and tendon-gliding; weeks 6–12 added functional grip, fine-motor activity, desensitisation and strengthening.

Reported outcomes

  • By week 12, MCP, PIP and DIP motion reached approximately 85%, 80% and 75% of normal, respectively; grip strength reached about 70% of the unaffected hand.
  • Thenar strength improved from 2/5 to 4/5, with independence in tasks such as buttoning, writing and utensil use.

Clinical lessons to consider

  • When tendon, nerve and arterial repairs coexist, rehabilitation must balance protected tissue healing with controlled tendon glide.
  • Progression should follow wound status, oedema, pain, clinical repair stability and movement quality rather than a rigid timeline.

Limitations — what this case cannot tell us

  • Single case with short-term follow-up; long-term nerve regeneration and sustained hand function remain uncertain.
  • Validated patient-reported outcome scales were not used.

Original source

Aydan Novruzova. “Orthopedic Rehabilitation Following Complex Repair of the Flexor and Extensor Tendons, Artery, and Nerve: A Case Report.” Cureus, 2025. DOI: 10.7759/cureus.99643

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This page is an independently written educational summary, not a reproduction of the full paper. Check the original article for complete methods, outcome tables, references and licensing.