What are tendons?
Tendons are cord-like structures that connect the muscle to the bone. The muscular contraction is transmitted via the tendon and results in movement of the bone and the associated joints.
The tendons on the front of the forearm and the hand (flexor surface/volar surface/palmar surface) are known as flexor tendons. These tendons enable us to bend our fingers(flex our fingers). The tendons on the back of our forearm and hand (extensor surface/dorsal surface) are known as extensor tendons. These tendons help us straighten our fingers(extend our fingers).
Deep cuts on the wrist, hand or fingers can injure the flexor/extensor tendons and adjacent nerves and blood vessels. The injury may appear simple on the outside but may be much more complex on the inside. When a tendon is cut, the end attached to the muscle(proximal cut-end) is retracted into the wound. When tendons are cut completely, the affected finger joints can no longer be moved.
How are tendon injuries treated?
Tendons are made of living cells. Healing will occur if the cut ends can be brought back together as the healing takes place through the cells inside as well as tissue outside the tendon. It is very unlikely that a cut tendon will heal without surgery as they separate after an injury.
Surgery is required to repair not only the tendons but also any adjacent injured nerves as well as blood vessels. It is important for tendon repair to be strong, yet not bulky. The repair needs to be strong because healing takes 4-6 weeks. However, the patient's finger needs to be moved earlier than this to prevent adhesions(repaired tendon getting stuck to the adjacent tissue). A stronger repair allows early mobilization of a repaired tendon. A bulky repair will prevent gliding of the repaired tendons through the limited space in the finger.
Hand therapy after tendon injuries
It is important to closely work with the hand therapist and your surgeon to understand and follow the therapy program after surgery. The tendon repair may pull apart if your hand is used too soon or therapy guidelines are not followed. If therapy fails to improve motions, surgery to remove scar around the tendon may be required.
This information provided is meant purely for educational purposes and may not be used as a substitute for medical diagnosis or treatment. You should seek the advice of your doctor or qualified healthcare provider before starting any treatment or if you have any questions related to your health, physical fitness or medical conditions.
Hand & Reconstructive Microsurgery Center