Hand Tendon Repair - Healthy (2023)

What is a hand tendon repair?

Hand tendon repair is a surgical procedure to repair damaged or torn tendons. Most tendon damage is caused by cutting the hand with glass or knives.

What are tendons?

Tendons are strong strands of tissue that connect muscles to bones. When you contract (squeeze) a group of muscles, the tendons attached to them pull on specific bones, which allows you to perform a variety of physical movements.

There are two groups of tendons in the hand:

• Extensor tendons – which run from the forearm through the back of your hand to your fingers and thumb, allowing you to straighten your fingers and thumb
• Flexor tendons, which also run from the forearm through the wrist into the palm, allowing you to flex your fingers

Why do I need tendon repair surgery?

A hand tendon repair is needed when one or more tendons in the hand split or tear (split), resulting in a loss of normal hand movement.

If your extensor tendons are damaged, you won't be able to straighten one or more fingers. When your flexor tendons are damaged, you can no longer flex one or more fingers.

Damaged tendons can cause pain and inflammation (swelling) in the hand. Below are some common causes of tendon injuries.

• Cuts: A cut in the hand can cause tendon injuries.
• Sports Injuries – Tendons can become overstretched and torn during sports. This is more common in contact sports like football and rugby, or high-grip activities like rock climbing.
• Bites: Animal bites can cause tendon damage. However, human bites are a more common cause, most commonly occurring when one person punches another person in the teeth, cutting their hand in the process.
• Crush injuries – Getting your finger caught in a door or your hand crushed in a car accident can tear or tear a tendon.
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  it can cause swelling in the tendons. In the worst case, this can lead to a tendon rupture.

tendon repair surgery

In tendon repair, an incision is made in the hand to locate the split tendon ends, and then the tendon ends are sewn together.

Extensor tendons are easy to access, so repairing them is relatively easy. Depending on the nature of the injury, it may be possible to repair the extensor tendons in an emergency room with a

to numb the affected area.

Repairing the flexor tendons is more complex because they can be difficult to reach and in many cases are located near important nerves. Flexor tendon repair should generally be performed under

in an operating room by an experienced plastic or orthopedic surgeon specializing in hand surgery.

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recovering from an operation

Both types of tendon surgery require a long recovery (rehabilitation) period because the repaired tendons will be very weak until the ends heal together. Depending on the location of the injury, recovery can take one to three months.

During rehabilitation, the tendons are protected from overuse with hand splints. A hand splint is a rigid support worn around the hand and designed to hold the hand firmly in place to prevent excessive movement that could cause the tendon to tear while it heals. You also need to do regular hand exercises to prevent the repaired tendons from sticking to nearby tissues.

When you can go back to work depends on your job. Light activities can usually be resumed after 6 to 8 weeks, vigorous activities and sports after 10 to 12 weeks. Read more about

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Panorama

You should have a functioning finger after an extensor tendon repair, but you may not be able to regain full range of motion. Outcome is usually better when the injury is a clean cut in the tendon rather than bruising or damage to bones and joints.

A flexor tendon injury is usually more serious as it is responsible for carrying more force than an extensor tendon. After a flexor tendon repair, it's not uncommon for some fingers to lose full range of motion, although tendon repair still gives better results than no surgery.

In some cases, complications arise after the operation, such as: B. infection or rupture of the repaired tendon or attachment to nearby tissue. Read more information about

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How is a hand tendon repair performed?

Before performing the operation,

your hand, wrist, and forearm to check for other damage, e.g. B. after a break that also needs to be repaired.

A tendon repair is not generally considered emergency surgery, but is usually performed as soon as possible after the injury (usually within 24 to 48 hours).

Because the longer the tendons are torn, the more scars form at the end of the tendons. This can result in a reduction in your hand's normal range of motion.

Depending on the nature of your injury, you may be given antibiotics and a

prick to prevent your hand from getting infected.

extensor tendon repair

Extensor tendon repair is usually performed at a

(also called regional anesthetic). A regional anesthetic completely numbs a part of your body with medication.

If your tendon has been damaged by an injury, the wound will be thoroughly cleaned with water. An incision will be made in your hand (or in the case of a wound, the wound may be enlarged) and the two ends of the torn tendon are sewn together.

A splint (a rigid support to protect the hand) is usually put on to prevent you from moving your hand and damaging the repaired tendons. The wound is then closed.

If nothing else has been damaged, the extensor tendon repair surgery takes about 30 minutes.

Flexor tendon repair

Flexor tendon repair is usually performed under regional surgery or

.

A tourniquet is placed on the upper arm to stop blood flow and to facilitate the safe performance of the surgery. A tourniquet is a type of cuff used to restrict (tighten) blood flow.

The surgeon then stretches the wound (or makes an incision if there is no wound) to locate the damaged tendons. You will use pliers to bring the two ends of the damaged tendon together. The tendons are then sewn back together and the wound on the hand is closed. A splint is placed to protect the newly repaired tendons.

A simple flexor tendon repair takes 45 to 60 minutes. Complex surgeries for more serious injuries can take much longer.

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Restoration of hand tendon repair

When you can go home depends on how badly your hand was injured. You can go home the same day after anesthesia and have made arrangements for aftercare.

after the operation

if you had one

, wake up in the recovery room after the operation. To help you breathe, you can wear an oxygen mask over your face. You may feel a little sleepy.

If you have a regional or

, you can return to your room earlier, but your arm will be numb and limp for several hours. It's normal to have your hand raised in a sling (a large bandage used to support a part of the body) to control inflammation (swelling) in the hand.

After the surgery, your hand will likely be bruised and swollen, and when the anesthesia wears off, it will hurt. You need pain medication such as

, up to two weeks.

You won't normally be able to drive, so you may need someone to drive you home. If you live alone and have been given general anesthesia you may be advised to spend the night in the hospital. You may also need to stay overnight if you need manual therapy in the hospital before going home.

Rehabilitation after extensor tendon repair

Before you leave the hospital, a hand therapist places your hand in a protective splint (a rigid support designed to protect the hand) to prevent overstretching of the repaired tendons.

Typically, you'll be advised to wear the splint full-time for at least four weeks, and then at night for the next two weeks.

You will learn many different manual exercises. These are intended to prevent the repaired tendons from sticking to the surrounding tissue, which would limit the freedom of movement of the hand.

Examples of hand exercises used in rehabilitation are:

• With the other hand, gently lift a finger off the rail
• Gently bend your knuckles as you slide the nails along the rail toward your palm

If you smoke, it is highly recommended that you quit as smoking can affect blood flow to your hand and delay recovery time.

Returning to work after extensor tendon repair

How quickly you can return to work and resume normal daily activities depends on the nature of your work and the nature and location of your injury. Most people can:

• Resuming light activities, such as using a keyboard or writing with a pen, after six weeks
• Driving a car or motorbike after eight weeks
• Resuming average activities, such as light lifting or stacking shelves, after eight weeks
• Driving a heavy goods vehicle (truck) after eight weeks
• Resume heavy activities such as weight lifting or construction work after 10 weeks
• Resumption of sports activities after 10-12 weeks

Your hand therapist or surgeon can give you a more accurate estimate of your likely recovery time.

It is very important that you follow all instructions and advice you are given regarding the use of your hands during the recovery period. If you attempt to use the repaired tendons before they have fully healed, they may tear.

Rehabilitation after flexor tendon repair

As with the extensor tendon repair, your hand will be placed in a protective splint.

It is usually recommended that you wear the splint continuously for at least four to five weeks and then at night for a further two weeks.

As with extensor tendon repair, you will learn various hand exercises to prevent the repaired tendon from sticking to the surrounding tissue. This includes:

• With the other hand, gently fold the fingers into the palm
• Gently straighten your fingers so the nails touch the rail

If you smoke, it is highly recommended that you quit as smoking can affect blood flow to your hand and delay recovery time.

Returning to work after flexor tendon repair

After flexor tendon repairs, most people can:

• Resume light activities after eight weeks
• Driving after eight weeks
• Riding a motorcycle after 10 weeks
• Resume moderate activities after 10 weeks
• Driving a heavy vehicle after 10 weeks
• Resumption of sports activities after 10-12 weeks
• Return to heavy activity after 12 weeks

Attempting to use repaired tendons before they have fully healed can cause them to tear.

Complications of hand tendon repair

Some common complications of tendon repair include infection, repair failure (which can result in tendon rupture), and adhesion of the repaired tendon to nearby tissue.

Infection

Postoperative infections develop in approximately 5% of tendon repair cases. The risk of infection is greater if you are in an environment with high levels of germs, such as B. a farm, hurt the hand. Crush injuries are also more likely to cause infection.

Symptoms that could indicate your hand has developed an infection include:

• Redness and swelling in the hand
• a feeling of tenderness or pain
• a high temperature (fever) of 100.4°F (38°C) or higher

Contact your doctor if you think you have developed an infection. Most infections can be successfully treated with antibiotics.

tendon cold

In about 5% of tendon repair cases, the repair fails. This leads to the tearing of the repaired tendon.

Most tendon ruptures occur immediately after surgery when the tendon is at its weakest. Tendon ruptures are common in people who don't follow advice on resting the affected tendon. Accidental tripping, falling or the splint suddenly snagging on an object can also tear the tendon.

Sometimes it's obvious that the tendon has snapped because you notice a sudden pop or "ringing" in your hand. However, you may not realize the tendon has snapped until you realize that you can no longer move your finger or fingers in the same way as before.

If you think your tendon has ruptured, contact your surgical team. Additional surgery is usually required to repair the tendon.

tendon adhesion

Tendon adhesion is a medical term meaning that the tendons have become attached to nearby tissue and have lost some of their range of motion, specifically the ability to move around bone. This movement is called tendon slipping.

This can result in some loss of movement, which is minor in most cases. The most severe cases of tendon adhesions require surgery to release the pinched tendon.