Tendon Injuries

Tendon injuries may occur on the flexor or extensor side of the fingers, hand, wrist or forearm. Overwhelmingly they occur as a consequence of penetrating trauma, but in some cases a forceful contraction of the tendon will pull it off its bony insertion, without an external injury. An inability to move the finger or hand following penetrating trauma should be considered a tendon injury until proven otherwise.

There are two flexor tendons to each digit and one for the thumb. These tendons are thick strong structures that exert incredible force (think climbers), yet they have a delicate surrounding bloody supply and run through an intricate array of pulleys in the fingers.

They also run very close to the crucial nerves and vessels that supply the finger. As such, they are complex injuries that if not repaired quickly, retract into the palm and will cause significant hand dysfunction.

  • Management

These injuries should be managed by a dedicated hand surgeon who has experience in the management of these injuries, as a strong repair needs to be executed in order to allow early range of motion to prevent adhesions forming between the tendon and the pulleys. There are also often associated nerve and vessel injuries that will be addressed at the time of surgery.

Crucial to the postoperative management of these injuries is strict adherence to a defined early active range of motion protocol in order to achieve an optimal outcome. Following tendon repair, the hand is placed in a splint in order to restrict the movement of the wrist and hand to some measure, so as not to place undue stress on the repair in the rehabilitation phase

For flexor tendons the splint needs to be in place for 4 weeks, whereas for extensor tendons it only needs to be in place for 3 weeks.

Conditions Managed

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