What are the rehabilitation options for fine motor control impairment following surgical repair of a partially severed Flexor Carpi Ulnaris (FCU) tendon?

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Last updated: February 25, 2025View editorial policy

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From the Research

To rehabilitate fine motor control after FCU tendon repair, I recommend a targeted exercise program focusing on wrist and finger dexterity, incorporating flexion fixation as an alternative to extension fixation, as it has been shown to achieve excellent Strickland ratings and improve active flexion range of motion of the distal interphalangeal joint 1.

Rehabilitation Options

The goal of rehabilitation after FCU tendon repair is to restore fine motor control and prevent further injury.

  • Start with gentle wrist flexion and extension exercises, gradually adding resistance using therapy putty or small hand weights.
  • Practice precision movements like picking up small objects (coins, marbles) and transferring them between containers.
  • Incorporate finger isolation exercises where you touch each fingertip to your thumb in sequence, gradually increasing speed.
  • Gaming-specific exercises include mouse precision drills where you trace patterns on screen at varying speeds.
  • Grip strengthening with stress balls or grip trainers can also help rebuild control.

Importance of Flexion Fixation

The study by 1 suggests that flexion fixation after flexor tendon rupture can achieve an excellent Strickland rating and is more effective than extension fixation, especially in terms of the active flexion range of motion of the distal interphalangeal joint.

Additional Considerations

  • Perform exercises for 15-20 minutes, 2-3 times daily, but stop if you experience pain.
  • Consistency is crucial for neural pathway redevelopment.
  • The effectiveness of these exercises stems from neuroplasticity - your brain's ability to form new connections that bypass damaged pathways.
  • Additionally, proper ergonomics while gaming (wrist support, appropriate mouse sensitivity) can prevent further strain.
  • If progress plateaus after 4-6 weeks, consult a hand therapist who can provide personalized techniques and possibly recommend modalities like electrical stimulation to enhance recovery.

Tendon Transfer Options

In some cases, tendon transfer surgery may be considered to restore wrist, finger, and thumb extension, as discussed in the study by 2. However, this should be determined on a case-by-case basis, taking into account the individual's specific needs and expectations.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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