Surgery is often used to repair damage to tendons in your hand. This usually also helps to restore movement in the affected fingers or thumb.
Tendons are tough cords of tissue that connect muscles to bones. They allow you to make a wide range of movements.
There are 2 groups of tendons in the hand: extensor tendons and flexor tendons.
Extensor tendons run from your forearm across the back of your hand. They allow you to straighten your fingers and thumb.
Flexor tendons run from the forearm through your wrist and across your palm. They allow you to bend your fingers.
Hand tendon repair
You'll need a hand tendon repair if one or more tendons in your hand rupture or are cut.
If the damage is to your extensor tendons, you'll be unable to straighten one or more fingers. Sometimes you can treat damage to the extensor tendons with a rigid support called a splint.
If the damage is to your flexor tendons, you'll be unable to bend 1 or more fingers.
Tendon damage can also cause pain and inflammation (swelling) in your hand.
Common causes of tendon injuries include:
- cuts across the back or palm of your hand
- sports injuries – such as stubbing a finger, grabbing or strenuous gripping
- bites – animal and human bites, or punching another person in the teeth can cause damage
- crushing injuries – jamming a finger in a door or crushing a hand in a car accident
- rheumatoid arthritis – can cause tendons to become inflamed and rupture in severe cases
Tendon repair surgery
Tendon repair may involve the surgeon making an incision (cut) in your wrist, hand or finger. This is so they can locate the ends of the divided tendon and stitch them together.
Extensor tendons are easier to reach, so repairing them is relatively straightforward. These are usually repaired while you are under a local anaesthetic.
Repairing flexor tendons is more challenging and usually requires a general anaesthetic.
Recovering from surgery
Both types of tendon surgery need a lengthy period of recovery. The repaired tendons will be weak until the ends heal together.
It can take up to 3 months for the repaired tendon to regain its previous strength. You'll usually need to wear a hand splint for several weeks after surgery.
You'll also need to perform hand exercises regularly during your recovery. This is to stop the repaired tendons sticking to nearby tissue, which can limit hand movement.
When you can return to work will depend on your job. Light activities can often be resumed after 6 to 8 weeks, and heavy activities and sport after 10 to 12 weeks.
Results of tendon repair surgery
After an extensor tendon repair, you should have a working finger or thumb. But you may not regain full movement. The outcome is often better when the injury is a clean cut to the tendon.
A flexor tendon injury is more serious because they're put under more strain. It's quite common for some fingers to not regain full movement. But the tendon repair will still give a better result than not having surgery.
Complications can develop after surgery, such as infection or rupturing of the tendon. In these cases, you may need further treatment.
Content supplied by the NHS and adapted for Ireland by the HSE