Tendon Injuries

Human hands are pretty remarkable grasping organ that exhibits great mobility and flexibility.

Human hand has dozens of bones, muscles, nerves, blood vessels, and more, all of which work in coordination to help perform everyday tasks.

Hand tendons play a key role in the function of hand – but are also a common source of hand injuries.

Tendons are cord-like structures that connect the muscles to the joints. They run along the forearm across the wrist and palm and into the fingers, allowing you to bend and open your fingers and thumb in order to grasp an object or make a fist. Injuries to the tendons can cause the loss of mobility over one or more of the joints in the hand.

What are the types of tendons that move your hand?

There are two sets of tendon Injuries that attach that move your hand:

• The flexor tendons are present on the palmar side of your hand. Flexor tendons help bend the fingers and thumb, allowing you to make a fist and grasp the objects.
• The extensor tendons are present on the back of your hand. Extensor tendons help straighten the fingers and thumb, thus allowing the hand to release an objects or loosen the grip.

In total, there are nine flexor tendons and 12 extensor tendons that move your hand and fingers.

How do common hand tendon injuries occur?

Tendon injuries occur a number of different ways, including:

• Sharp injuries like knives, box cutters, and sheet metal
• Industrial injuries, like with table saws and cutters
• Falling while holding fragile objects, e.g. glass bottles and ceramic bowls
• Traction injuries or forceful pulling, like getting the hand stuck in a rope or a machine
• Sustaining direct trauma, like punch during fight or fall on hand

What are the symptoms of a hand tendon injury?

Hand tendon injuries can present several different ways, depending on the type and severity of the injury.

Common symptoms of a hand tendon injury include:

• Inability to fully bend or straighten a finger or thumb
• Pain when attempt to bend the finger
• Tenderness along the finger on the volar or extensor side of the hand
• Numbness in the fingertips
• Swelling
• Drooping of the finger

How are Tendon Injuries treated?

It is important to see a doctor whenever the hand or fingers are injured. This is especially true for an open injury when there is a likely chance of having a tendon injury. Generally, it is recommended that flexor tendon injuries should be repaired within 7 to 10 days of the injury, although early evaluation is important.

First Aid – Tendon Injuries Surgery

When you have and injury or cut to your hand or fingers:

• Apply a compression bandage to your hand to slow down the bleeding.
• Wash the wound with sterile saline to reduce the risk of infection.
• Elevate your hand by keeping it lifted above your heart to reduce swelling.
• See a doctor as soon as possible or to an emergency center to evaluate your hand for a tendon, nerve, blood vessel, or bone injury.
• You may need a tetanus shot or antibiotics to prevent infection.

Physical Examination – Tendon Injuries Treatment

1. During the physical examination, your doctor will ask you to bend and straighten your fingers. In order to test the finger strength, your doctor may ask you to bend your injured finger while they hold the other fingers down flat. To determine whether any nerves or blood vessels have been injured, your doctor may test your hand for sensation and blood flow to the fingers.
2. Tendons that are completely cut typically require surgery.
3. A hand surgeon will determine the best course of treatment.

Treatment – Human Tendon Injury 

• After examining your hand, your doctor may suggest you tendon repair surgery as per the physical findings.
• Injured tendons cannot heal unless the cut ends are approximated. In majority of cases, a cut or torn tendon must be repaired by a surgeon.
• Surgery is usually performed within 7 to 10 days after an injury. In general, the sooner surgery is performed, the better recovery will be.

Because tendons may be torn in different ways — such as straight across, at an angle, or pulled right off of the bone — so there are many different methods for your surgeon to repair them. Most, if not all of the methods for repair, require special sutures and suturing techniques.

After repair your fingers and wrist may be placed in a bent position in a splint to keep tension off the repair.

What happens after hand tendon Injuries? 

• The tendon repair takes approximately 3 to 4 months to heal before your hand is strong enough to use without restrictions.
• Your surgeon may refer you to a physiotherapist who specializes in the treatment of the hand, wrist, and elbow for rehabilitation of the repaired tendon.
• You will be fitted with a customized splint to protect the repaired tendons for approximately 6 weeks.
• During that period, only controlled range of movements are allowed and exercises are progressed each week based on the surgical treatment.
• Each injury is different, and therefore each rehabilitation protocol is individualized.
• Your physiotherapist will guide you through the appropriate physiotherapy protocols.

What are possible complications?

As with any surgery, there’s the potential for complications after hand tendon surgery, including:

• Dehiscence of the repaired tendons if the precautions are not properly followed
• Infection
• Limited motion due to scar tissue adhesion

Overall, despite its challenges, tendon repair surgery results in good return of function and high patient satisfaction for most patient who strictly comply with post-operative hand therapy protocols.