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PNA RESEARCH CASE LIBRARYHand / Orthopaedic 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 involving the flexor and extensor tendons of the index and middle fingers, radial artery and median nerve. Following surgical repair, the report describes a staged rehabilitation programme balancing tendon protection with recovery of movement and hand use.

Clinical findings

  • Loss of flexion and extension in the second and third fingers, absent radial artery pulse, median-nerve-distribution sensory loss and edema were reported.
  • Baseline finger range of motion was markedly restricted and grip strength was 15% of the unaffected hand.

Rehabilitation described in the report

  • Weeks 0–3: splinting, passive flexion, active extension and edema control to protect repairs.
  • Weeks 3–6: controlled active movement, tendon-gliding and light resistance; weeks 6–12: functional grip, fine-motor and desensitization work.
  • Progression was linked to wound healing, pain and edema, repair stability and movement control.

Reported outcomes

  • At week 12, finger motion reached 85% of normal at the MCP joints, 80% at PIP and 75% at DIP joints.
  • Grip strength reached about 70% of the unaffected hand; thenar strength improved from 2/5 to 4/5, with independence in several fine-motor tasks.

Clinical lessons to consider

  • Combined tendon, nerve and vascular injuries require close coordination with the surgical team and a carefully staged protection-to-function plan.
  • Early controlled movement must respect repair stability and tissue-healing criteria.
  • Measure both impairment-level outcomes and meaningful hand activities.

Limitations — what this case cannot tell us

  • Short-term follow-up only; long-term nerve recovery and sustained function remain uncertain.
  • Validated DASH or Patient-Rated Wrist Evaluation scales were not used in the report.

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.