Tendon Lacerations

Selected Features of Our Program

Evaluation and Diagnosis

There are 9 tendons that bend and 9 tendons that extend the fingers and the thumb. Any of them can be easily lacerated by simple cuts of the hand since they are all close to the surface of the body. When the tendons that bend (flexor tendons) the digits are cut, nerves and blood vessels are often involved. Tendon lacerations can easily be overlooked. Examination by an expert in hand surgery as soon as possible after injury is essential. There is a limited period of time after injury during which repair is still possible. Tendon lacerations can cause major long-term problems with hand function and should be taken very seriously.

Treatment and Recovery

As soon as the tendon damage is confirmed by the hand surgeon, plans for repair should be made. Direct repair of the tendon is best, but back-up plans for tendon grafting or transfer should always be available in case the original tendon proves unsatisfactory. The problem following tendon repair is that the damaged area of the tendon tends to stick to everything around it. When this happens, it won't move back and forth or glide properly. This problem of getting stuck in scar tissue is the worst for flexor tendon injuries of the fingers. To fight against the scar problem, the repaired area of the tendon must be moved back and forth right away. However, moving the repaired area puts stress on it and can cause rupture of the repair. For these reasons, new stronger repairs have been designed that fit together with more modern rehabilitation protocols. The early stages of healing are finished by 6 weeks. Full light use of the hand is allowed at this time. Unrestricted use is possible by 10 weeks. If everything goes well, the patient can achieve excellent results from this otherwise very serious problem.