Thumb UCL Repair/Reconstruction

Wrist & hand

27 Sept

Written By

Download this rehabilitation protocol (PDF)

For patients and physiotherapists.

Week 0-1

Maintain mobility through other fingers
Keep dressings and plaster dry

Week 1-2

Wound check and removal of sutures
Change to TPS – thumb spica. To be worn at all times
Encourage AROM through other joints; also thumb IPJ

Week 3-4

Ongoing AROM including thumb IPJ
TPS to be worn majority of the time, can come out for hygiene

Week 4-6

Commence AROM at MCPJ of thumb in A/P plane
Avoid pinch grip – which can lead to radial deviation
Continue to wear splint most of the time

Week 6-12

Wean TPS
Full range of motion
Only restriction is to avoid sustained pinch or grip till 12/52 post op

Some General Questions

What to expect after surgery:

Most patients will have day surgery only
After your operation, you might notice some numbness to fingers of the operated hand. This may be secondary to local anaesthetic and will wear off over 48-72 hours.
You will have arrangements made for hand therapy prior to discharge. It is important to be seen within 3-4 days of surgery as early hand therapy is vital to your rehabilitation
You will be sent home with medications or a script to help with pain relief

Time in Sling:

Generally your sling is for comfort only
You will have a plaster splint on discharge but this will be converted to a thermoplastic splint within the first few days by your hand therapist.

Return to Activity

Work: Depends what you do. Desk based work can be done from 1-2 weeks post operatively, if you can do these tasks single handedly. Otherwise generally 6 weeks before you can use both hands freely whilst seated. For manual work, it depends on what kind of lifting/pushing you do, but generally not before 3 months
Drive: In Australia, you can’t drive unless you are in full control of both your arms. Therefore, whilst you’re in a sling or have a splint on, you cannot drive. Generally 6 weeks post operatively.
Sports/Hobbies:

Gentle swimming: after 6 weeks
Gardening (light tasks only): 8-12 weeks
Bowls: after 3 months
Golf, tennis, badminton, squash: after 4-6 months
Weights: commence after 3 months

Concerns or questions?

If you have any concerns post operatively, or you would like further information, please contact Mr Lau through the VBJS on 03 5752 5020 or via email at admin@vbjs.com.au

If you need urgent medical help, call 000 or go to your nearest emergency department.

These notes have been prepared by Mr Simon Lau. They are general overviews and information aimed for use by his patients. They reflect Mr Lau’s views, opinions and recommendations. They do not constitute medical advice. The contents are provided for information and education purposes only. Please seek Mr Lau’s specific advice with any questions regarding medical conditions and treatment.