East Bay Hand and Plastic Surgery Logo

510-791-9700

FLEXOR TENDON INJURIES
Tendons are what let you bend and straighten your fingers. In a sense, you operate your fingers by remote control - the muscles which move your fingers are located up in your forearm, not in your fingers.

The most common and difficult problem that people have after a tendon injury is stiffness - losing the ability to either fully bend or straighten the finger - which can be permanent. This is a possible problem for anyone who has had a flexor tendon injury. Surgery and other special treatment is usually needed to make this as little a problem as possible.

Causes
Most often, flexor tendons are damaged from a cut. Fingers have special creases which let the skin fold when you make a fist - at these points, the tendons are just beneath the skin, and are easily injured by even a small cut in the skin.

Less often, flexor tendons may tear or be torn off the bone by a sudden pull against a strong grip, without tearing the skin.

What Can I Do?
Ice, elevation, and have it checked out by a doctor. If the injury involved a cut, medical evaluation is particularly important - to check whether or not a tetanus shot, antibiotics or other treatment is required, even if stitches aren't needed.

After injury, if surgery is needed, there is a limited amount of time to operate and get the the best possible result. Surgery delayed for more than two weeks has less of a chance of having a satisfactory outcome.

What Can a Doctor Do To Help?
Confirm that this is the problem, and check for nerve injury or other problems which can occur at the same time. Treatment really depends on the type of injury. Your doctor may recommend:

•Moving the fingers and doing exercises right away.

•Hand therapy.

•A splint or a cast, along with special exercises.

•Performing surgery to repair the damage.

HOW SUCCESSFUL IS TREATMENT?
It depends on many things - getting full motion back is less likely if:

•there is a nerve injury or a broken bone next to the tendon injury

•there is a long healing period before surgery

•the person is prone to thick scars

•the damage was caused by a crush injury

•there are problems participating in hand therapy after surgery

In addition, there are many other factors which can also affect the odds of having a good result versus a stiff hand.

After a flexor tendon injury, most people lose some movement in the finger, despite all efforts. It really takes everything going in your favor, including luck, to have a full recovery. However, if all goes well, the hand will work better after surgery than if surgery were not done, and that's the reason for doing it.

What Happens if I Don't Have Treatment?
It depends on what has happened, but unlike other injuries in the body, cut tendons don't heal well on their own.

If the tendon has been cut through and through, you won't be able bend one or both of your finger knuckles again.

If the tendon is cut part way through, it may heal up on its own, or it may tear apart completely a week or two later - or it may get stuck and stop working.

If you decide to have surgery later, it is much more of an ordeal - two operations instead of one, and twice as long to recover.