Figure 1: The tendons of the hand run from the flexor muscles in the elbow and forearm to the bones of the fingers.  They may result in significant short-term and long-term impairment in function. Too much empathy? Tendon injuries. Therapy for flexor tendon injuries is provided on site at the University of Michigan’s Hand Program by our team of occupational and physical therapists under the direction of a trained hand therapist. About 15 years ago, when I was working with the hand surgeon, I was home trying to pry apart a package of frozen sausage links and stabbed myself in my left ring finger. If you are worried about a flexor tendon injury, please see a hand surgeon right away. Flexor tendon injuries do not heal by themselves and frequently require surgery to put the injured tendon back to its normal position. People often confuse the three, or are unsure how they work together in the body. They are usually caused by a penetrating injury and if not repaired can result in severe functional loss. Her lack of adherence to the instructions caused her retinae to detach again, and she is now 80% blind in that eye. Splints may be used for as little as 2-3 weeks or in some instances up to 3 months. If your extensor tendons are damaged, you'll be unable to straighten one or more fingers. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. The incidence of acute traumatic tendon injuries in the hand and wrist: a 10-year population-based study. Author Information . Your doctor can also assess whether you have similar problems such as bursitis (inflammation of the fluid \"cushion\" surrounding the joints). When a muscle or tendon as been overstretched, the result is a strain. A specialized hand therapy program may include a . A sprain occurs when a ligament in the finger, hand, or wrist stretches, but doesn’t tear. Chapter 48 Extensor and Flexor Tendon Injuries in the Hand, Wrist, and Foot Peter E. Sokolove and David K. Barnes Extensor Tendons Extensor tendons are quite superficial, covered only by skin and a thin layer of fascia, and are thus highly susceptible to injury by commonly experienced trauma. Extensor tendons, located on the back of the hand and fingers, allow you to straighten your fingers and thumb (see Figure 1). An extensor tendon injury can happen from a minor cut to jamming a finger. There are surgeons whose specialty involves repairing hand wounds and injuries. Twisting? Extensor tendon injuries are usually easier to treat than flexor tendon injuries, and they have better postoperative results. 1,2. If the tendon is lacerated or avulsed (pulled off the tendon’s insertion point) an operation to identify the ends of the damaged tendon and repair the ends together, or the avulsed tendon back to its insertion, is usually required. Typically, any additional injured structures are repaired at the same time as the tendon. Seek immediate help if you are experiencing a medical emergency. I had to show the surgeon (my boss) what I did- I was so embarrassed! If the muscle/tendon injuries are partial (incomplete) then rest and supervised movement are often sufficient for a very good recovery. These were compared to the numbers of 2009-2012 and 1998-2001. Extensor Tendon Injury. Maxwell, Shane DO; Olson, David MD, FACSM. Once a tendon is re-injured or once the surgical repair is disrupted, it is not reasonable to expect an optimal outcome on follow-up surgeries. Cover it with a towel. Muscle repair is difficult as the tissues do not hold stitches (sutures) well. Crushing injuries, such as jamming fingers in a door frame, animal bites, sports injuries, and … Extensor tendon injuries are usually easier to treat than flexor tendon injuries, and they have better postoperative results. In this case, we take the extra index finger tendon … Extensor tendon injuries. He repaired the wound. If your hand begins to hurt around your thumb or wrist, you may have tendonitis of the hand.Repetitive activities involving your hand and wrist often cause this irritation and inflammation of the tendons in your hand. What happened exactly? No heavy activity is allowed until three months post-surgery because the tendon repair may fall apart before it is robust enough to withstand force or heavy weights. This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. When repairing tendons, we typically stitch them using strong, carefully place sutures, but even after repair, damaged tendons are not as strong as the undamaged tendon. Tendon injuries tend to be stab-type injuries, which is why the bagel cutter injury is so prevalent. Splints are often used for closed (no wound) injuries. Primary care for these injuries consisted in wound debridement and skin suture. You'll never regret that you did, but you may regret that you didn't. And, when they are not, we still need to know that they are healthy and working! Results. Common soft tissue conditions in the hand include trigger finger (finger tendon pain) and De Quervain's Tenosynovitis (thumb tendon pain). For this reason tendon injuries of the hand are usually hard to ignore. Methods: This retrospective study was conducted on acute traumatic tendon injuries of the hand treated at our institution from 2005 to 2013, based on medical records and X-ray findings. The thumb flexor tendon (flexor pollicis longus) runs through the … Dynamic splintage and controlled active … This prevalence of males versus female patients was also observed by Saini et al, in Hand tendon repair is carried out when one or more tendons in your hand rupture or are cut, leading to loss of normal hand movements. They lie next to the bone on the back of the hands and fingers and straighten the wrist, fingers and thumb (Figure 1). There is a lack of evidence from RCTs on most of the rehabilitation interventions used following surgery for flexor tendon injuries of the hand. When any of the tendons in your hand are lacerated (cut) or pulled off their insertions, their function is lost. This makes them prone to injury due to the lack of muscle or other protective tissues. The challenge to the surgeon is to re-attach the muscle to the bone in a way that glides smoothly within the pulley system of the hand. I still have the scar. Rest the injured tendon until pain and swelling have decreased. The incidence of acute traumatic tendon injuries in the hand and wrist: a 10-year population-based study. Tendon Injuries Extensor Tendon Injuries. ↑ 8.0 8.1 de Jong JP, Nguyen JT, Sonnema AJ, Nguyen EC, Amadio PC, Moran SL. When trying to wedge a sharp blade between the links, the knife can suddenly give way and end up stabbing the hand. Tendons link muscles to bones, the primary hard tissues t… Erik Moberg had adopted these principles and … Methods: We performed a retrospective population-based … multiple tendon injuries. This close … 53 flexor tendons were injured (average 1.5 digits per patient … Flexor tendon injuries in children J Hand Surg Br. Tendons being reattached with surgical sutures. An injured tendon can cause problems bending or straightening the fingers, depending on which tendon is affected. Use an ice pack, or put crushed ice in a plastic bag. In this blog, Dr. Ather Mirza and Dr. Justin Mirza, orthopedic physicians at Mirza Orthopedics, outline some common symptoms of flexor tendon injuries. Sometimes our feelings outrun pragmatism and safety, and patients begin doing more than they've been advised to do after they start to feel better. This is why instructions from your surgeon and occupational or physical therapist must be followed to the letter. Address for correspondence: Shane Maxwell, DO, University of Minnesota, Minneapolis, MN; E-mail: [email protected]. Surgeons do not have that luxury—and neither do you as the patient. Patients were divided into 2 groups: a … 1994 Dec;19(6):696-8. These injuries are classified according to the system of Leddy and Packer 11 based on the degree of retraction. Learn from her example. I should've known the previous pics were too graphic, but I guess I'm desensitized after being in surgery for so many years. In about 5% of tendon repairs, the repair … If pregnant or nursing, consult with a qualified provider on an individual basis. Ice helps prevent tissue damage and decreases swelling and pain. First, it’s useful to understand the basics of ligament, tendon, and muscle anatomy. Figure 3: After surgery, the area of the injured tendon must be protected from … Apply ice on your tendon for 15 to 20 minutes every hour for 48 hours or as directed. A tendon can also be partially cut. Background: Acute traumatic tendon injuries of the hand and wrist are commonly encountered in the emergency department. This means "inflammation of the tendon." For a severed tendon to heal, it is necessary to surgically intervene soon after the injury is acquired and suture the proximal and distal ends of the tendon.This is because the forearm muscles that control the tendons of the hand will cause a severed tendon to retract internally from the site of the original wound. 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