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Our well-trained hand surgeons evaluate patients with flexor tendon injuries and advise an individualized treatment plan. There are several conservative and surgical treatment approaches available to treat flexor tendon injuries. The treatment is chosen based on the severity of the condition.
The hand has a complex combination of ligaments, muscles, tendons, nerves, skin, bones, multiple joints and blood vessels. These are all intricately arranged to function efficiently. Flexor muscles help in bending and moving our fingers. These flexor muscles on the side of the palm have structures like cords called tendons, which help in bending the fingers and connecting muscles to the bones. When the fingers are bent these flexor tendons slide through the tunnels which are called tendon sheaths.
Flexor tendons run very close to the skin and an injury to the palm, forearm, or wrist due to a tear, cut or burn can damage the flexor tendons resulting in impaired or no movement to the fingers. Since these flexor tendons are cord-like structures like rubber bands on a stretch, a cut to these cords will pull the cut ends far apart through the tunnels and they do not join and heal on their own. Since nerves and blood vessels are very close to it, they can easily get damaged and result in lack of sensation to the other extremity of the finger and lack of blood supply. Therefore, surgery is sometimes necessary to restore the hand to its normal functionality.
If the flexor tendons are torn or ripped apart, surgical intervention will be required to join the tendons by stitching them together with special sutures.
Depending on the extent of the injury and the urgency of treatment the doctor will decide when and what type of surgery needs to be performed. Most often, surgery is performed on an outpatient basis. A dressing will be applied on the area of surgery and a splint will be placed to protect your hand and enable it to heal quickly by restricting its mobility. These splints usually are made of plastic and will be positioned in such a way that the patient will have to have the fingers bent to reduce tension and stretching of the flexor tendons.
In a tendon repair surgery, the surgeon will make a small cut on the skin near the damaged tendon. The torn ends will be stitched together with special surgical sutures. If they cannot be joined together, tendons from other parts of the body like foot or toe will be used to join and suture the ends. The surrounding areas of the tendons like blood vessels, muscles, nerves, bones will be checked for damage. If damages are seen, corrective surgical procedures will be performed on them. The cuts made will be closed with sutures and the surgical area will be covered with a sterile dressing and placed in a splint to reduce mobility and facilitate quicker healing. To avoid pain at the time of surgery, either local, regional or general anesthesia will be administered.
The healing of flexor tendons can take up to 2 months to move it without splints. It will take an additional month to regain regular movements and usage of the hand. Following surgery the patient will be suggested physiotherapy and exercises. Adhering to these activities will help in a speedy recovery.
Symptoms of flexor tendon injuries are as follows:
The above symptoms enable a quick identification of flexor tendon injury, but diagnosing partial flexor tendon injury is not easy. MRI scan is the best possible option to find the extent of injury of flexor tendons. With MRI images, doctors can decide if surgery will be required or not.
Some of the risk factors that can lead to flexor tendon injury are:
Some of the causes for flexor tendon injuries are:
When there is a partial tear or rupture without the tendons being torn apart, the doctor will suggest restricting the movements of fingers and hands to facilitate the healing of ruptures and partial damages of flexor tendons. Usually the hands, fingers will be placed in casts and splints to reduce mobility and further injury.
Cold ice padding to the surface of the affected area can reduce inflammation and pain. Care must be taken to avoid water spilling on the damaged skin. The ice cubes will have to be placed in a sealed plastic bag, wrapped in a clean cloth before starting the cold ice treatment.
Once the casts or splints are removed, doctors will suggest physical exercises to the hands and fingers, to decrease stiffness and improve the strength and flexibility of tendons, nerves, and muscles. This physical therapy will have to be followed for a few months till the hands and fingers will have enough strength to perform normal chores of everyday life.
Here are certain measures that can be followed in order to prevent flexor tendon injuries:
Are you suffering from an injury of the flexor tendon? For any questions, information or guidance regarding the treatment of flexor tendon injury, get in touch with our skilled hand surgeons at Cedars-Sinai Marina del Rey Hospital.
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