Hand tendon repair is surgery designed to repair injured hand tendons, helping restore movement in the affected fingers or thumb.
Tendons are tough cords of fibrous tissue that connect muscles to bone. When muscles contract, the tendons at the end of these muscles pull on the bones. This allows for a wide range of movements.
There are two main groups of tendons in the hands:
Running across the back of your hands, from your forearm across your hand, extensor tendons allow you to straighten your fingers and thumb.
Running through your forearm, wrist and across the palms of your hands, flexor tendons allow you to bend your fingers and thumb.
Hand tendons can get cut or rupture, making it difficult or impossible to move certain fingers or the thumb. Common causes of such injuries are:
Hand tendon injuries typically cause pain, swelling, tenderness, redness and inability to move the joints. The pain is worse when trying to move the affected joint and may be accompanied by popping, clicking or crackling.
When an extensor tendon is damaged, you won’t be able to straighten one or more fingers. If a flexor tendon is affected, you won’t be able to bend the affected finger.
Mild hand tendon injuries, like tendon sprains, can be treated with simple immobilization with braces or splints. Pain medication and steroid injections can be used to ease pain and swelling in these cases.
Hand tendon cuts and ruptures often require surgery to restore movement in the injured fingers or thumb. Most patients need to wear a hand splint for several weeks following surgery and perform hand exercises to restore movement.
If you sustain a deep cut or laceration across your fingers or hand, it is best to go to your local emergency room or urgent care to get assessed by a medical provider. They may then close the skin and contact a hand surgeon to arrange for follow-up.
Surgery is required for severe tendon injuries involving ruptures and cuts. While not considered an emergency, this type of surgery should be performed as soon as possible, preferably within days after injury. That’s because the longer you wait to have your injured tendon repaired, the more scar tissue will form around the injury, which can impair future mobility of your fingers or thumb.
Tendon repair surgery can be performed under local or general anesthesia, depending on the location of the injury and the surgical technique used.
Surgery typically takes 30 to 60 minutes to complete. You will likely go home on the day of your surgery. You will also need to wear a splint for several weeks as you recover.
To determine if you are a candidate for hand tendon repair, your hand surgeon will look at your tendons to see if your injury is causing problems with hand motion. You will also need to have an X-ray of your hand to check for fractures and other problems that might require additional treatment.
Candidates are usually patients whose tendon injury involves cuts and ruptures that lead to loss of normal hand movements. If you are unable to straighten or bend one or more fingers following a tendon injury, chances are you are a candidate for this surgery.
Before surgery, your surgeon may request imaging and blood tests to help prepare you for surgery. You will also be given instructions on how to prepare for your appointment.
Most patients need to avoid all food or drink on the day of their surgery, especially if undergoing general anesthesia. We may ask you to discontinue medications and supplements that thin the blood, such as NSAIDs, Aspirin, warfarin, vitamin E and turmeric, to name a few. Plan to take some time off work and arrange for a drive back home.
Extensor tendons are easier to reach and repair, so surgery on these tendons can be performed under local anesthesia. Flexor tendons are difficult to reach and require complex surgical techniques, so patients are usually placed under general anesthesia for their repair.
You will be lying down during surgery, with your hand extended to your side. Your surgical team will cleanse and sterilize the treatment area, and Dr. Sharma will make an incision above and below the injured tendon. He will stitch together the two ends of the cut or ruptured tendon. When this isn’t possible, he may reattach the damaged tendon to a healthy tendon or use a graft or artificial tendon.
Once the tendon has been repaired, Dr. Sharma will close the incision with sutures and immobilize the affected finger with a splint.
You will be able to go home on the day of your surgery once the effects of anesthesia wear off. At home, you will need to follow Dr. Sharma’s post-op instructions:
Do not attempt to remove the splint. Wear your splint at all times for three to four weeks, and only at night when instructed to do so. Keep it dry by placing a plastic bag over it when you shower.
Keep your hand elevated above heart level to prevent swelling and bruising. You can use a sling or the foam pillow we will provide you with. Take over the counter pain medication as prescribed to reduce any discomfort.
Tendon healing takes time, usually three months to achieve full strength. To help with your recovery, an occupational therapist will teach you range of motion exercises that you may need to perform for several weeks.
Tendon repair surgery itself is not painful as it involves anesthesia. After surgery, it is normal to experience mild to moderate discomfort, which most patients can manage at home with prescription pain relievers.
Tendon repair is not necessary after tendon sprains and strains or when the injury does not affect hand mobility.
Generally speaking, clean cuts of the tendons that are put back together within a week do very well. Flexor tendons take a little longer than extensor tendons to heal, but most patients regain 80 to 95% of the preinjury range of motion.
Tendons take time to recover after tendon repair — at least three months to regain full strength. It can take six to 12 months for the full range of motion to return after this surgery.
Avoid driving immediately after surgery, especially if prescribed narcotics. Avoid straining your hand too much with physically demanding tasks until your tendons have fully recovered.
Tendon ruptures and cuts can limit normal hand movement and cause disability if not treated early and properly. At Plastic Surgery Austin, we regularly perform tendon repairs using the latest techniques and technology to maximize patient outcomes.
Contact Plastic Surgery Austin today to schedule a consultation with Dr. Sharma. He will help you decide on the best course of treatment so that you can recover your full range of motion with minimal risk of complications.
Call us at 512-838-3658 or connect with us online now!
Contact our office to schedule a private consultation with Board Certified Plastic Surgeon, Sanjay K. Sharma, M.D., F.A.C.S.
