Tendons are tough cords of tissue that connect muscles to bones allowing you to make a wide range of movements.
There are two types of tendons in the hand:
Extensor tendons run from the forearm across the back of your hand to your fingers allowing you to straighten your fingers.
Flexor tendons run from your forearm through your wrist and across the palm of your hand, allowing you to bend your fingers.
Wounds on the hand and fingers are particularly serious and complex because of the importance of structures that can be injured. A small-looking wound may be associated with a major nerve, vascular, or tendon injury.
In addition to cuts on the arm, hand, or fingers, certain sports activities can cause flexor tendon injuries. These injuries often occur in football, and rugby. “Jersey finger” is one of the most common of these sports injuries. It happens when a player grabs another’s jersey and the finger gets caught and pulled. The tendon is pulled off the bone.
Certain health conditions (rheumatoid arthritis) weaken the flexor tendons and make them more likely to tear.
The most common signs of a tendon injury include an open injury such as a cut and an inability to bend or extend one or more joints of your fingers.
This can also happen without warning or injury and the person may simply notice that one or more finger suddenly no longer moves.
The examination of the hand and fingers are the key of the diagnosis. Anyone suspecting a tendon injury should be evaluated by a surgeon specializing in hand surgery. This should occur as soon as possible as the functional outcome after repair is affected by the length of time between injury and repair.
Tendon injuries are repaired surgically. This repair involves bringing the two tendinous stumps together and suturing them according to specific techniques so as to ensure the best slip while obtaining maximum strength. This procedure must be protected by a splint and a rehabilitation protocol will be established immediately. Healing of the tendons may be the cause of adhesion formation between the tendon and the underlying bone structure, limiting tendon gliding. The scar tissue that forms can prevent flexion and full extension of the finger. Surgery to release the tendon from these adhesions can sometimes be useful in cases of significant loss of mobility.
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