Lateral band transfer surgery: aftercare advice

You have undergone surgery to realign the small tendons around the middle joint on one or more of your fingers. The aim of the surgery is to try and stop the middle joint from moving further than normal, as this can cause painful catching or the finger getting stuck in a position.

Over the next few weeks you will be given advice by your therapist about your rehabilitation and the management of your hand. Getting a good result from this surgery is directly related to the commitment you put into your rehabilitation. Following the advice in this leaflet is very important. If you have any questions, please speak to a member of your clinical team.

This leaflet explain the following.

• How to protect the surgical site, and avoid activities or positions which might damage the surgical site.

• How to care for your wound after surgery.

• How to look after your protective splint.

• The exercises you need to do to help your recovery.

We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please speak to a member of your healthcare team.

General aftercare advice

• Keep your shoulder and elbow moving regularly throughout the day. This helps to prevent stiffness and improve circulation throughout your arm.

What will happen at my first hand therapy appointment?

Around 3 to 5 days after your operation, you will usually have your first hand therapy appointment. This appointment should be arranged before your surgery.

At this appointment:

• your surgical dressings will be removed; and

• you will be fitted with a thermoplastic splint.

This splint must be worn at all times, until at least 4 weeks after your operation. The splint is designed to keep the fingers in a slightly bent position, to avoid overstretching your operated finger.

Only remove your splint when it needs to be cleaned. Your therapist will show you how to do this, if appropriate. For more information, see How do I care for my splint? below.

When can I start my normal activities again?

Do not use your operated finger for any activities in the first 4 weeks after surgery. This includes driving, housework, gardening, sports, and work. Depending on which finger has been operated, your therapist will advise you on when it is safe to begin certain activities.

How do I care for my wound after surgery?

Keep your wound and dressings dry at all times, until the wound has healed. If your dressing gets wet, you will need to have this changed either by your GP or at an Urgent Treatment Centre. 

Your dressing should be changed every 3 to 4 days, unless you have been told otherwise by your therapist.

You may have dissolvable stitches. These will gradually fall out and disappear around 2 weeks after your surgery.

If you have non-dissolving sutures, these will be taken out around 2 weeks after your surgery, either by:

• your therapist at your follow-up appointment; or

• by the nurse at your GP surgery.

If you have them removed by your GP practice nurse, you will need to book this appointment yourself.

Once your wound has healed, your therapist will advise you to begin scar massage. Your scar will fade over time, which can take up to 2 years or more. However, there are some things you can do to help it heal, and scar massage can help improve how it looks. For more information, please read our Scar massage leaflet or speak to your therapist.

If you have any concerns about your wound, please contact your therapist, your GP, or your nearest Urgent Treatment Centre.

If your splint needs to be removed by another health professional to examine or redress your wound, please tell them that you are unable to fully extend the finger in order to protect the surgical site.

How do I care for my splint?

• You must wear your splint all day and night for at least the first 4 weeks.

• After 4 weeks your therapist will assess the position of your finger and discuss with you whether further splinting is needed. Most people will continue with night splinting for at least 6 weeks in total.

• Your splint is custom made to fit your finger, so you must not wear any other splint. 

• Do not alter your splint or add padding to your splint.

• Do not put your splint near hot surfaces / objects, such as a radiator or a hot water bottle.

• Contact the therapy department if your splint rubs or causes any swelling or irritation.

• If your splint needs cleaning, you may remove it and wash it in lukewarm water. Towel dry thoroughly before placing it back on your hand. If you do need to remove the splint you need to make sure the finger is kept in a bent position.

Exercises

• Complete your exercises every hour during the day.

• Before starting the exercises, remove the strap or straps nearest the end of your finger. Leave the strap around the base of the finger in position. This should allow you some bend in your finger, but you will not be able to fully straighten it.

1. 
   Before strap nearest the end of your finger is removed.
2. 
   After strap nearest the end of your finger is removed.

• The following exercises should not be painful. They may feel slightly uncomfortable as your fingers and hand are moving.

• Always exercise gently and slowly.

• Hold your position for 5 seconds at the end of range.

Table top to flat fist exercise

• Complete this exercise 5 times.

1. 
   Start with your fingers comfortably straight in the splint.
2. 
   Bend at the joint where the finger meets your hand. Keep the back of the finger touching the splint.
3. 
   Gently bend the middle joint, so that your finger tips move towards your wrist.
4. 
   Slowly move back to the start position.

Hook to full fist exercise

• Complete this exercise 5 times.

1. 
   Start with your fingers comfortably straight in the splint.
2. 
   Bend the top and middle joints of your fingers into a scratch position.
3. 
   Move your hand towards a fist.
4. 
   Slowly move back to the start position.

It is normal for these exercises to be uncomfortable, but they should not cause pain. If they do:

• Try gentler / smaller movements, with less repetition.

• Build up slowly.

• It is better to do smaller movements with good technique, than forcing your fingers to move into pain.

4 weeks after your operation

Most patients will be able to start wearing the splint less after 4 weeks. Your therapist will show you how to reduce the amount of time you are using the splint, Every patient is different, so please do not reduce your splint use until advised by your therapist or the surgical team.

Your therapist will discuss which exercises you need to continue with. They will tell you if any additional exercises are needed, and when you can start to return to day to day activities.

What if I have any questions or concerns?

If you have any questions or concerns regarding your treatment, please call the Physiotherapy Department on 01227 783065.

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