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Tendon Injuries in the Hand: Repair, Splinting & Getting Movement Back

Your hands have an intricate network of tendons. So, a sports injury, work place injury, glass injury, or crush injury, can cause damage to the tendons, resulting in impaired movements of the fingers and the thumb.

A tendon injury may be small and unassuming on the exterior but may have significant damage underneath and require early evaluation and proper treatment to avoid stiffness or reduced finger movement.

Patients with hand tendon injury can consult Dr. Geetika Paliwal, reconstructive specialist in Indore, for an evaluation and a suitable treatment and rehabilitation plan.

What Are Tendons in the Hand and What Do They Do?

The tendons are strong bands of tissue that connect the muscles to the bones. There are two main sets of tendons that are responsible for the movement of the fingers- flexor and extensor tendons.

Flexor Tendons

The flexor tendons are usually located on the palmar (palm) side of the hand and fingers. They allow for the bending of the fingers and bring them closer to the palm. The flexor tendon injury can prevent the normal bending of the fingers.

Extensor Tendons

The extensor tendons run along the dorsal (back) of the hand and fingers. They enable finger extension (straightening) and thumb straightening and are commonly injured during hand injuries.

Causes of Hand Tendon Injuries

Tendon injuries can be a result of:

  • Glass, knife, or metal cuts
  • Road traffic accidents
  • Workplace accidents
  • Sports injuries
  • Crush injuries
  • Falls
  • Animal bites
  • Fractures or dislocations
  • Sudden pull on the finger
  • Wounds that are deep and involve the hand or wrist

An injury that may appear trivial may also involve the tendon injury beneath.

Symptoms of a Tendon Injury

The symptoms may vary depending on the tendon injured and if it is completely or partially injured. The most common symptoms are:

  • Inability to bend a finger
  • Inability to straighten a finger
  • Reduced grip or weak finger movements
  • Painful finger movements
  • Swelling and tenderness
  • Deep cut on the skin over the hand or finger
  • Unusual position of the finger
  • Reduced strength in the grip

Even if the fingers appear to have some movement, a patient may still have a partial tendon injury if a deep wound has occurred and must be evaluated by a hand specialist.

Flexor Tendon Injury

The flexor tendon injuries usually affect the palm side of the hand or finger. Injury to the flexor tendon can result in inability to bend the affected finger joint. Since the flexor tendons are very deep in the fingers and pass through small tunnels, special rehabilitation measures are taken to aid its healing. Sometimes the adjacent nerves and blood vessels may also be injured.

Extensor Tendon Injury

An extensor tendon injury is usually on the back of the hand and/or fingers. The injury can result in the inability to straighten the finger. Depending on the extent and the location of the injury, the treatment can range from splints to surgical repair of the tendon.

How Are Hand Tendon Injuries Assessed?

The doctor will typically examine the wound and assess the movement of each finger and the thumb. Various tests are done, to check for:

  • Ability of each finger to bend
  • Ability of the fingers to straighten
  • The strength of movement
  • Sensitivity of the fingers
  • Blood circulation
  • Any associated fractures or joint injury
  • Nerve or blood vessel injury

An x-ray may be advised to rule out fractures, foreign bodies, or any other associated bone injury.

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How Long Will the Recovery Take?

The recovery time varies for different types of tendon injuries. It depends on a number of factors like:

  • Which tendon is injured
  • The location of the injury
  • Whether the tendon was completely or partially cut
  • Associated nerve or bone injury
  • Type of surgery performed
  • The healing process of the patient and adherence to the splinting and therapy program

The patient is encouraged to follow their hand therapist’s advice for safe and effective movement. Usually, the movement and strengthening is increased gradually, following a structured therapy program and may continue to improve for months. Patients should not resume lifting weights, sports, or forceful hand movements until they are cleared by their surgeon. Anyone who is unable to bend or straighten their finger(s) after a deep cut or injury should see a hand specialist as soon as possible. Patients with hand injuries can consult Dr. Geetika Paliwal in Indore, for an assessment and treatment plan.

Conclusion

Hand tendon injuries usually require more than just a routine wound closure and the patient may need to be evaluated by a hand specialist. Patients with cuts or crush injuries or loss of function of their fingers can meet Dr. Geetika Paliwal, plastic surgeon in Indore, for management of their hand tendon injury. The tendon repair, if required, splinting, and wound care are decided based on the evaluation. Patients are then placed on a rehabilitation program, to aid the healing of the tendon and regain useful movement of their fingers.

FAQs

A hand tendon injury occurs when one of the tendons responsible for bending or straightening the fingers becomes stretched, partially torn, or completely cut.

Difficulty bending or straightening a finger after a deep cut is an important warning sign. Even if some movement remains, a partial tendon injury may still be present and should be assessed.
Patients with suspected tendon injuries can consult Dr. Geetika Paliwal in Indore for evaluation and discussion of suitable treatment options.
Not every tendon injury requires surgery. Some partial or closed injuries may be managed with splinting, while completely divided tendons often require surgical repair.
A splint protects the repaired tendon from excessive tension while it heals. It also keeps the hand in a controlled position during the early recovery period.
Movement is usually introduced according to a carefully planned rehabilitation protocol. The timing depends on the tendon repaired, injury pattern, and strength of the repair.
The choice of reconstruction depends on the size and depth of the wound, location of the injury, condition of surrounding tissues, blood supply, presence of exposed bone or tendon, fractures, and the patient’s overall health. The surgeon selects the most suitable reconstruction method after a detailed assessment.
Recovery varies between patients. Tendon healing takes several weeks, while improvements in movement, strength, and coordination may continue for several months.
Without appropriate rehabilitation, the finger may become stiff or the repaired tendon may develop adhesions that restrict movement. Therapy should always follow the treating surgeon’s recommended protocol.
Many patients regain useful hand and finger movement after appropriate repair and rehabilitation. The final outcome depends on the severity of the injury, associated damage, scar formation, and participation in therapy.