The flexor tendons on the palm side of the hand are used to bend the fingers. A deep cut in the palm side of your hand, fingers, wrist or forearm is likely to damage or even sever the flexor tendons, which are quite close to the surface of the skin.
Because tendons are under tension as they connect muscle to bone, the ends pull far apart when torn or cut, like a rubber band, making it impossible for the injured tendon to heal on its own. Without appropriate treatment, a flexor tendon injury can cause you to lose the use of your fingers, thumb or entire hand. A cut in this area of the hand may also involve important nerves and blood vessels, resulting in numbness or inadequate blood supply.
Urgent surgery may be necessary. Occasionally, flexor tendons may be partially cut or torn. With a partial tendon tear, it may still be possible to bend your finger, but not completely. These types of tears can be difficult to diagnose. The most common signs of a flexor tendon injury include: a cut or open injury on the palm side of your hand, often where the skin folds as the finger bends; inability to bend one or more joints of the finger; pain when the finger is bent; tenderness along the finger on the palm side of the hand; and numbness in the fingertip.
In addition to cuts, certain sports activities can cause flexor tendon injuries. Participants of football, wrestling, rugby and other similar sports may suffer "Jersey finger," where the tendon is pulled off the bone. Certain health conditions rheumatoid arthritis , for example weaken the flexor tendons, making them more susceptible to tearing.
Without warning or injury, a person may realize the finger no longer bends, without knowing how it happened. If you suffer a serious cut to your hand or fingers, apply ice immediately. Tightly wrap your hand with a clean cloth or bandage to slow down the bleeding, and keep your hand elevated above your heart. See a doctor as soon as possible for treatment, which may include a tetanus shot or antibiotics to prevent infection. Whenever your fingers are injured, even if the skin is not broken, it is very important to be examined by a physician.
This is especially true if the finger is jammed and you cannot bend or straighten your fingertip. In order to determine the extent of your injury, your physician will perform an examination that may include evaluating the strength of your fingers as well as your ability to bend and straighten them.
Testing your hand for sensation and blood flow to the fingers will help verify if any nerves or blood vessels have also been injured. An X-ray may also be necessary to see if there is any damage to the bone.
Following the examination, your physician may place your hand in a splint for protection prior to surgery. If your tendon is partially torn, depending on the injury, your orthopaedic surgeon may recommend a nonsurgical treatment that includes the same splinting and exercise programs used for surgery patients. Because the ends of a torn or severed tendon no longer touch, in most cases, it must be surgically repaired to heal properly.
Typically, the sooner surgery is performed the better the outcome, so it is usually performed no later than 10 days after the injury. If the blood flow to your hand or finger is restricted, however, your orthopaedic surgeon may schedule your surgery immediately. It can take up to 2 months before the repair heals and your hand is strong enough to use without protection.
Another month or so may be needed before your hand can be used with any force. Hand tendon repair is needed when 1 or more tendons in your hand rupture break or split or are cut, leading to the loss of normal hand movements. If your extensor tendons are damaged, you'll be unable to straighten 1 or more fingers. If your flexor tendons are damaged, you'll be unable to bend 1 or more fingers.
Tendon damage can also cause pain and swelling inflammation in your hand. Sometimes, damage to the extensor tendons can be treated without the need for surgery, using a rigid support called a splint that's worn around the hand. Tendon repair may involve a surgeon making a cut incision in your wrist, hand or finger 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.
Read more about how hand tendon repair is performed. Both types of tendon surgery require a lengthy period of recovery rehabilitation because the repaired tendons will be weak until the ends heal together.
Depending on the location of the injury, it can take up to 3 months for the repaired tendon to regain its previous strength.
Rehabilitation involves protecting your tendons from overuse using a hand splint. This lack of movement can involve just a small area in your hand, or it can be the inability to move multiple joints in the arm. The level of impairment depends on where the injury is located.
The flexor tendons in the arm, wrist and hand are in very close proximity to nerves and arteries. It is not unusual to have numbness, tingling and a lot of bleeding after a tendon is lacerated.
This is because there can be an injury to these other vital structures as well. These additional injuries are less common in a flexor tendon injury not caused by laceration. For any laceration, it is very wise to see a doctor as soon as you can, particularly if you notice any change in function of the arm.
If you are worried about a flexor tendon injury, please see a hand surgeon right away. It is often easier to treat these injuries early after injury. Flexor tendon injuries do not heal by themselves and frequently require surgery to put the injured tendon back to its normal position. When surgery is required, a splint and hand therapy may be used after the procedure to protect you and to aid in recovery. Typically, any additional injured structures are repaired at the same time as the tendon.
Tendon injuries can result in scarring and stiffness after the surgery. It is not unusual to need additional surgery to improve stiffness. Typically, hand therapy is started after the procedure to aid your recovery.
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