Tendon injuries
Tendons connect muscles to bones and allow the fingers to move. Flexor tendons bend the fingers and extensor tendons straighten them. A cut, even a small one, on the palm side of the fingers or hand can divide a tendon, and the finger can no longer bend on its own.
Cut tendons do not heal by themselves. They need to be stitched, ideally within the first days after the injury. If the wound is clean, repair is done as soon as possible; if it is contaminated or seen late, reconstruction can be done in stages (secondary tenorrhaphy or tenoplasty with a tendon graft).
There are also injuries without a cut, for example rupture of the extensor tendon at the fingertip (“mallet finger”), which is often treated with a splint.
Nerve injuries
The digital nerves and the nerves of the hand carry sensation and control the muscles. A cut nerve causes numbness in the matching area and sometimes muscle weakness. Nerves are repaired under a microscope or loupes, with stitches much finer than a hair. Regeneration is slow, about a millimetre a day, and is better in younger people.
Why timing matters
The sooner the repair is done after the injury, the better the functional result. That is why a cut to the hand followed by inability to move a finger, or by numbness, should be assessed without delay.
Recovery
After tendon or nerve repair, the hand is kept in a splint for about 3–6 weeks, followed by a rehabilitation programme with a hand therapist. Full recovery takes months. Doing the exercises is decisive for the result.
Risks and things to know
- tendon adhesions, which limit movement and may need further surgery;
- rupture of the tendon repair if the hand is used too early;
- incomplete recovery of sensation or strength;
- joint stiffness.
Results vary from one patient to another.
