There are two types of tendons in the hand: extensor and flexor. Extensor tendons run along the top of the hand and fingers and enable straightening of the fingers and thumb. Flexor tendons attach muscles in the forearm to the bones in the fingers, enabling bending. Hand tendon surgery should be performed by a specialized hand surgeon in an operating room setting.
The surgeon will make an incision in the skin above the damaged tendon to evaluate the injury. Any damaged tissue will be removed. The ends of the tendon will be sewn back together. If the remaining tendon is too short, the doctor will graft healthy tendon tissue from another area to allow the ends to meet. Tendon will be taken from an area of the body that has two tendons but can function with one. Once the tendon has been connected, the surgeon will stitch the incision closed. The wound will then be dressed and a splint may be required to allow the tendon to properly heal.
If too much strain is put on the tendon post-surgery, it may re-tear. Following your post-surgery instructions is crucial for recovery. You will be required to wear your splint at all times for the first 3-6 weeks, at minimum. Your hand therapist will go over hand exercises that should be performed daily to help prevent the tendon adhesion- connecting to surrounding tissue and restricting range of motion.
Plan ahead, as you will likely not be able to drive for 8-10 weeks post-surgery. For the first few days post-surgery, you may notice pain and inflammation in the area as the body begins to heal itself. Keep the area elevated above the level of the heart to reduce pain and swelling. Weeks 3-6 you may experience stiffness but will begin to notice an increase in range of movement. You may be able to resume light activities after 6-8 weeks. Swelling should be significantly reduced or gone by 10-12 weeks and the tendon should be back to full strength. You may be able to return to heavy activities and sports. It may take up to 6 months to regain full range of motion.
The three most common hand tendon surgery complications are infection, rupture and adhesion. Contact your doctor if you experience any of these symptoms.
Infection- Signs of infection are redness and swelling, increased pain or tenderness and a high temperature of over 100.4 degrees. Medication will be prescribed to treat the infection.
Rupture- A tendon may rupture if it is strained before adequately healing. You may feel a snap, but occasionally you may only realize it after you can no longer move your finger/s like before. If this occurs, another surgery may be required to correct the damage.
Adhesion- Tendon adhesion occurs when the tendon attaches to surrounding tissue and reduces range of movement. Performing daily hand exercises as prescribed help to prevent this complication. Occasionally, the adhesion is severe and may require an additional surgery.
The team of hand specialists at Midwest Hand Surgery are skilled at hand tendon repair. To schedule an appointment with one of our hand surgeons, please click here or call 630-359-6888.
There are some things you should know before undergoing hand tendon surgery. More about the surgery and its recovery here.
Flexor tendon injuries make it difficult or impossible to do things like hold an object, pinch or any do other grasping activities. Read about the causes and treatments.
Three signs that a hand may have a tendon injury and some insights into what to do about it.