After undergoing a procedure with the CoNextions TR® Tendon Repair System, a patient will begin their rehabilitation process. The patient will be guided by their surgeon to begin regaining their Range of Motion (ROM) of the repaired area(s). The patient should follow the advice of their surgeon or designated medical professional to get the best outcomes in healing after surgery. Rehabilitation often differentiates between each case and the surgeon’s preferences. This protocol is designed to give an example of the rehabilitation process for the CoNextions TR® Tendon Repair System.
Protocol
Dr. William Gowski, MD, at the Orthopedic Specialty Clinic in Salt Lake City, Utah, and Scott Nobis OTR/L CHT, provided their standard rehabilitation protocol for a Flexor Tendon repair in Zone 2, after using the CoNextions TR Tendon Repair System (as of April 24, 2024).
Week 1-5
Splint: Forearm based dorsal blocking splint – wrist flexion at 20 degrees, MP (metacarpophalangeal) flexion at 60-70 degrees, IP (interphalangeal) joints in a neutral position.
Exercises: (Out of the splint)
- Full Active Range of Motion (AROM) for fingers, focusing on flexion and extension, performed out of the splint in a tenson free and gentle manner.
- Full passive finger flexion. Place and hold finger flexion. Then full active finger extension.
- Wrist tenodesis exercises.
- Scar and edema management.
- Squeeze a yellow foam block halfway.

Week 5
Splint: Same dorsal blocking splint as before.
Exercises: (Out of the splint)
- Blocked Distal Interphalangeal (DIP) and Proximal Interphalangeal (PIP) flexion and involved fingers.
- Active composite and individual wrist and finger flexion/extension.
- Repeat exercises from weeks 1-5 (steps 1-2 and 4-5).
- Light grip with a red foam block.

Week 6
Splint: Remove dorsal blocking splint except for sports and when protection is needed. Initiate buddy straps to involved fingers.
Exercises: (Out of the splint)
- Repeat exercises from Week 5 (Steps 1-4).
- Passive composite wrist and finger flex/extension stretching.
- Progressive light strengthening with yellow putty and tubing for grip, pinch, and wrist initiated.
Week 8
Splint: Remove buddy straps.
Exercises:
- Full active, passive, blocked exercises for fingers and wrist for full ROM.
- Continue progressive strengthening with putty and tubing for grip, pinch, and wrist as needed.
Week 12-16
Full Return to activity without restrictions per MD.
Conclusion
This protocol outlines the gradual progression of splinting and exercises over several weeks to rehabilitate and regain full function after a flexor tendon injury in Zone 2. It’s important to follow the guidance of the medical professional overseeing the treatment.
This document is intended solely for the use of healthcare professionals. CoNextions does not dispense medical advice and recommends that surgeons be trained in the use of any product before using it in surgery. A surgeon must always rely on his or her own professional clinical judgment when deciding whether to use a particular product when treating a particular patient and rehabilitation protocol is case dependent. As emphasized in the instructions for use for the device, physical therapy programs should be administered with appropriate restrictions based on the level of patient healing and adherence to approved physical therapy protocols.
For indications, contraindications, warnings, precautions see IFU www.conextionsmed.com or contact your local representative for additional product information
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