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Tendon Repair of the Hand
Tendon repair is a surgical procedure performed when the tendons that move your fingers and thumb have been damaged, torn, or ruptured. This can occur with both the flexor (finger bending) and extensor (finger straightening) tendons. These surgeries are known as flexor tendon repair and extensor tendon repair. The tendons in your hand connect the muscles in your forearm to the bones of your fingers allowing your fingers to bend and straighten. When these tendons are damaged it affects your ability to perform these movements. These tendons run close to the surface of the skin and so are easily damaged through cuts or torn away from the bone through blunt trauma or crush injuries.
Conservative treatment (non surgical) can be undertaken when the affected tendons are less than 50% damaged or ruptured. Here, the hand is placed in a protective splint and Physio.co.uk would manage under the same guidelines as we would a fully torn tendon. Surgery is required if your tendon injury is limiting the use of your hand, preventing it from fully functioning. Depending on the type and location of injury and the location of injury there are two possible surgeries.
- Reattachment of the tendon to the bone. Here the tendon is stitched back on to the bone. Internal splints may also be used in order for the tendon to be anchored back on to the bone.
- Reattachment of the tendon. Here the tendon has been cut in two and so the ends of the tendon are sewn together
Tendon repair surgery is an invasive surgery and healing times are subsequently affected. Full recovery following extensor and flexor repairs is approximately 12 weeks. Surgery is usually undertaken immediately following tendon rupture and so your physiotherapy programme will begin following this.
Above: Functional hand exercises assisted by physiotherapistPhysiotherapy before HandTendon Repair Surgery
Pre-operative physiotherapy is aimed at protecting the initial injury and helping to reduce post-rehabilitation complications and time. Physio.co.uk will provide treatment that will help protect the immediate injury and provide the platform for effective healing and rehabilitation. Treatment includes:
- Cryotherapy – to minimise swelling
- Protective bracing for support and to reduce risk of contractures and
- Pain management and education
Symptoms after HandTendon Repair Surgery
Following hand tendon repair surgery your hand will be stitched, bandaged and placed in a protective splint(4-5 weeks)in order to protect the repair and maximise rehab potential. It is essential to approach these repairs with caution as the structures are very weak and vulnerable to re-injury. Common symptoms following hand tendon repair surgery include:
- Swelling and bruising
- Pain
- Stiffness
- Decreased range of movement and strength
- Sensory symptoms – numbness usually self resolves
Physiotherapy after HandTendon Repair Surgery
Following hand tendon repair surgery, Physio.co.uk can immediately compile a thorough assessment of your hand and develop a personal rehabilitation programme specific to your needs. Rehab will focus not only on restoration of movement and strength but on activities needed to return to active work, hobbies and sports. Treatment will begin following your surgery and full recovery can be seen within 12 weeks.
Weeks 1-3
Initial Physiotherapy will revolve around careful wound monitoring and pain management. This initial phase is necessary in order to prevent re rupture of the tendon and promote tendon healing. Initial treatment will include:
- Cryotherapy (Ice).
- Pain management.
- Electrotherapy
- Hand splinting.
- Controlled passive movements of wrist and fingers.
- Active movements of elbow and shoulder to prevent stiffness, loss of movement and strength.
- Wound monitoring
Weeks 4-6
After three weeks of physiotherapy your programme with Physio.co.uk will focus on a continuation and progression of exercises to increase range of movement, release tight structures and develop strength in your fingers. Treatment will include:
- Pain and wound management
- Scar management
- Hand splinting.
- Soft tissue mobilisation
- Increased passive movements of wrist and hand.
- Active and active assisted range of movement of affected tendon.
Weeks 7-12
During the later stages of your rehab, you will have seen marked improvements in movement and strength. It is necessary now to intensify your sessions with Physio.co.uk in order to maximise hand mobility and restore previous levels of function. Treatment will include:
- Initiation of strengthening exercises
- Full passive range of movement exercises.
- Increased active range of movement exercises
- Progressive wrist and finger strengthening exercises.
- Isolated strengthening of repaired tendon.
- Hand dexterity
- Soft tissue massage
- Functional activity exercises
Summary
Tendon repair is a common surgery performed to either your wrist extensor or flexor tendons. These tendons can easily be torn preventing fully functioning use of your hand and it is necessary to undergo a specific progressive rehabilitation programme to help restore movement and strength. Physio.co.uk will develop a comprehensive rehabilitation programme to ensure success of the operation, guarantee the return of full function and prevent any future problems occurring. Call Physio.co.uk now on 0330 088 7800 for more information or to book an appointment please contact us.
