Flexor tendons are a set of tendons located on the palm side of your hand that aid in the flexing of your fingers. They are an extension of the flexor muscles, located in the elbow and forearm areas. Cord-like in nature, they connect the muscles directly to the bone. When you bend your fingers, they pass through small tunnels known as tendon sheaths that keep them in place next to the bones. When they are injured, you either lose the ability to flex your fingers or it becomes incredibly painful to do so.
There are several ways flexor tendons can be injured. Flexor tendons are quite close to the surface of the hand and are easily injured with a moderate to deep laceration to the hand, fingers or even the arm, especially on the palm side. When this happens, the tendon is usually severed, making it impossible to bend the finger or fingers of the affected tendons. Not all injuries result in a severed tendon; sometimes tendons are simply stretched out, pulled off the bone or partially torn. These types of injuries often occur during sports and activities that require a lot of hand strength, like rock climbing.
There are several symptoms that may be indicative of a flexor tendon injury. If you notice any of the following, it is best to contact your doctor:
Not all of these symptoms are the result of a flexor tendon injury, but if you notice that it is not healing or dissipating, it is a good idea to have it evaluated. A thorough evaluation by your doctor will determine if there is a flexor tendon injury present, and the nature of the injury.
Flexor tendons are like a rubber band, always under tension. When injured, the ends of the tendons pull apart. Because they are made of living cells that need to be connected to heal, once they separate they cannot heal on their own, often requiring surgery. There has been recent evidence that determines some partially torn tendons do not require surgery, but rather can be healed with the same physical therapy that follows surgical repairs. This type of treatment should not be relied upon until a thorough assessment is given.
If your injury requires surgery, there are different approaches depending on how the tendon is torn. The type of injury you have will determine the necessary surgical procedure the doctor performs. In some instances, it may be required to repair nerves or blood vessels if they are affected by the injury. Surgery will take place within 7 to 10 days after the injury is diagnosed, sooner if the blood vessels are damaged restricting blood flow to the finger. During the surgery special stitches are placed in the tendon to facilitate repair.
After surgery, you will have sutures and likely a protective splint that keeps your hand in a bent position to prevent any tension on the repaired flexor tendon. The amount of stitches you receive is dependent on the surgery itself and ranges between Motion will be limited and you will be prescribed physical therapy.
After surgery, it is necessary to undergo physical therapy in order to improve your function and range of motion. Physical therapy also helps to offset the stiffness that follows a surgical repair of the flexor tendon. While the amount of therapy you receive is based on your prognosis, you can expect to receive at least 10 to 12 weeks.
Recovery time after a flexor tendon injury and subsequent surgery can take up to several months after the surgical procedure depending on the number of tendons involved and severity of the injury. Most patients are able to use their hand lightly within 2 months. After 3 months, most patients are able to use their hands like they did prior to the injury.
In some instances, a second surgery may be necessary. This usually only occurs in a small amount of flexor tendon injuries and is necessary to remove scar tissue that has built up thus restricting motion.
Please call our office at (703) 574-2588 for more information, or to schedule an appointment with Dr. Fadi Nukta in Northern Virginia.