Tendon Injuries and Treatments
Tendons are tough fibers that connect our muscles to our bones. Many tendon injuries occur at or near joints such as the shoulder or elbow. A tendon injury may appear to have happened very suddenly, but tendon injuries are usually a result of many tears to the tendon over a period of time.
Most tendon injuries are the result of wear and tear of the tendon that happens gradually from aging and overuse. Any person can suffer a tendon injury, but individuals who participate in activities that require repetitive motion, usually at work, during sports, or as part of a daily activity are most likely to damage a tendon.
Extensor Tendon Injuries
Extensor tendons allow your fingers, thumb, and hand to straighten or extend. Extensor tendons are attached to muscles located in the forearm that extend down to the fingers and are joined by smaller tendons attached to muscles in the hand. The small tendons in the hand allow finger motion and coordination, allowing you to use your hands to complete ordinary tasks. Due to the location of the extensor tendon, it is very susceptible to injury – even by a cut that appears to be minor. Injury to the extensor tendon can also be caused when a finger is jammed, causing a tendon to rip away from the bone.
Among the many injuries that may happen to the extensor tendon, mallet finger is fairly common. Mallet finger occurs when the fingertip cannot be straightened, which causes a droop at the end joint where the extensor tendon has been injured through separation from the bone or has been cut. Injuries usually result from a laceration or a jammed finger. Your plastic surgeon will recommend a special splint to help keep your finger straight. The type of splint is based on the location of the injury and will be determined by your physician. You will be required to wear the splint until the tendon has had time to heal. Removing the splint too early may result in a drooping finger. Make sure you follow your physician’s recommendations on the appropriate time to remove the splint.
Another common injury to the extensor tendon is known as boutonniere deformity which occurs when the middle joint of the finger remains in a bent position, resulting from a cut or tear in the tendon. If a cut has occurred, you will need stitches to repair the tendon. The middle joint of the affected finger will be splinted to keep it straight until the tendon has healed completely. If for some reason the injury is not treated or the splint is worn incorrectly, the finger may continue to bend and finally stiffen in a bent position. Follow your physician’s recommendations to prevent further injury and complications and to allow the quickest possible healing time.
How is an extensor tendon injury treated?
Most extensor tendon injuries are treated with splints, which should be worn until the tendon has fully healed. However, when there is a laceration to the tendon, hand surgery is often required. At The Centre for Working Hands, we are now using the Teno Fix Tendon Repair System when applicable, which enables early active range of motion and an earlier return to work. With Teno Fix, your hand surgeon installs an innovative soft-tissue anchor into each end of the tendon. A braided stainless steel suture is then inserted through the anchor, allowing the severed tendon ends to be reattached.
What should I expect?
Tendon injuries can result in the tendon attaching itself to a bone or scar tissue. Fractures and infections can affect the seriousness of the injury. Scar tissue may prevent a finger from fully bending or straightening. To improve your range of motion, therapy may be required. The Centre for Working Hands offers a comprehensive range of therapy services in our rehabilitation department.
Flexor Tendon Injuries
Flexor tendons allow the hand and fingers to bend, or flex. Flexor tendons are located in the forearm and extend to the fingers on the palm side of the hand. The thumb has one, large flexor muscle, and each finger has two. In the finger, one tendon attaches to the middle bone and bends the finger at the base of the finger and at second joint. The second tendon attaches to the tip of the bone at the fingertip and bends all three joints.
When there is a deep cut at the palm of your hand, the tendon acts as a rubber band and will contract and move farther apart as the finger straightens out. A tendon that is not completely cut may still allow the fingers to bend but can cause pain or catching of the tendon, which may later rupture. When both of the tendons on a finger are cut, the finger will not be able to bend on its own.
Due to the separation that occurs after a flexor tendon injury, these injuries are unable to heal without intervention. Depending on the cut and location of the hand injury, your hand surgeon will advise you on the specific treatment program you may need for optimal healing. Your finger or thumb may require a protective splint to prevent the tendon from pulling apart before it has healed. Make sure you follow your hand surgeon’s directions to help reduce complications.
Your surgeon may also prescribe therapy to help with scar tissue, which may make it difficult to bend and straighten the finger. Therapy is a normal part of the healing process. If you are instructed to attend therapy sessions, make sure you follow your surgeon’s and hand therapist’s instructions very carefully to help reduce the possibility of further injury. The Centre for Working Hands offers a comprehensive range of therapy services in our rehabilitation department.
To learn more about how you can benefit from our tendon injury treatments, call or email our expert therapists at The Centre for Working Hands to schedule your evaluation.