American Association for Hand Surgery

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Current Therapy Approaches in the Postoperative Management of Zone II Flexor Tendon Repairs
Materi Miranda, OTD, CHT1, Samantha Kogler, OTS2, Carly Jo Kersavage, OTS2, Kyle Turcott, OTS2, Lucas Richer, OTS2, Maggie Miller, OTS2 and Cynthia Ivy, OTD, OTR/L, M.Ed., CHT2, (1)Northern Arizona University, gilbert, AZ, (2)Northern Arizona University, Phoenix, AZ



There are a variety of options available for rehabilitative treatments of zone II flexor tendon repairs. A survey was distributed to understand current therapy approaches in the postoperative management of zone II flexor tendon repairs and compare them to recent literature deemed “best practice”.


A survey was developed through consultation with an expert in the field, a focus group and a sample survey. It was then sent through the email list provided by the Hand Therapy Certification Commission to determine current trends in immobilizing and treating flexor tendon repairs. The survey management tool utilized was Qualtrics™. The survey was delivered to 2,559 certified hand therapists on 1/23/2018 with the completion date 3/13/2018. The majority of answers from the survey were compared to best practice and determined to be consistent or inconsistent. Best practice was determined by reviewing the literature and examining the Maintenance of Certification of Best Practice for Flexor Tendons from the American Association of Hand Surgery.


There were 458 respondents, a response rate of 17.69% (458). Three survey answers were consistent with best practice while four answers were inconsistent. The remaining questions did not have a well-defined best practice correlation.


There is inconsistency between current research on best practice and the survey findings for when early active range of motion is initiated, return to unrestricted activity, and initiation of tenodesis/synergistic wrist motion. Consistency between best practice and survey findings include initiation of light functional tasks, time frames for making a full fist, and orthosis cessation.

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