THIS POST IS PART OF THE ULTIMATE GUIDE TO HAND, WRIST AND ELBOW INJURIES. People often confuse the three, or are unsure how they work together in the body. When surgery is required, a splint and hand therapy may be used after the procedure to protect you and to aid in recovery. Extensor tendon injuries are usually easier to treat than flexor tendon injuries, and they have better postoperative results. The injuries were analyzed, and the results were compared with the current literature. Hand injury may be associated with skin laceration, penetration or contusion of the hand. These injuries often occur in football, wrestling, and rugby. For example, an injured extensor tendon may prevent the fingers from fully straightening the fingers although making a fist can still be … Flexor tendon injuries in that part of the hand were to be treated only by surgeons skilled in surgery of the hand. If you are worried about a flexor tendon injury, please see a hand surgeon right away. 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. There is always a small loss of straightening in the finger long-term due to the injury, although this is reduced by the treatment in the splint. Figure 3: After surgery, the area of the injured tendon must be protected from … There is a lack of evidence from RCTs on most of the rehabilitation interventions used following surgery for flexor tendon injuries of the hand. Hand injury is a very common presentation both in primary care and in the accident and emergency department. Referrals to local providers can be arranged closer to home as a more convenient option for patients. Hand therapy: Hand therapy aims to balance protection of the tendon with splints with gradual loading or movement of the tendon with exercises. My advice is to seek a hand surgeon. Too much empathy? The incidence of acute traumatic tendon injuries in the hand and wrist: a 10-year population-based study. Tendon damage can also cause pain and swelling (inflammation) in your hand. 2014 Jun 1;6(2):196-202. If you are suffering from a tendon injury of the hand, seek medical attention immediately. Extensor tendon injuries are usually easier to treat than flexor tendon injuries, and they have better postoperative results. First, it’s useful to understand the basics of ligament, tendon, and muscle anatomy. Author Information . How she wishes she had listened to her doctor's instructions! It has a significant drawback, though, which prevents me from using it any longer. Our hands are constantly involved in daily activities and relatively superficial location of tendons in the hand, especially in the fingers, renders them susceptible to trauma. It is often easier to treat these injuries early after injury. The hand therapy programme is individualised. Tendinitis may cause finger tendons to swell, making it difficult for the tendons to glide through these tunnels. When trying to wedge a sharp blade between the links, the knife can suddenly give way and end up stabbing the hand. Strength will come back to the tendon as the tendon heals. These were compared to the numbers of 2009-2012 and 1998-2001. When any of the tendons in your hand are lacerated (cut) or pulled off their insertions, their function is lost. Gentle passive motion can be started early. A tendon can also be partially cut. Good function of flexor tendon system in the hand, especially fingers, is based on intactness of a fascinatingly complex, smart, gliding mechanism (Picture 1). Maxwell, Shane DO; Olson, David MD, FACSM. Crushing injuries, such as jamming fingers in a door frame, animal bites, sports injuries, and … And, when they are not, we still need to know that they are healthy and working! Injuries to the delicate tendons of the hands can be traumatic and debilitating. 1,2. One recent study found 33.2 tendon injuries to the hand/wrist per 100,000 person-years. Hand surgeons deal with tendons every day and should be considered the experts in the field. As you straighten your finger, a painful … Background: Acute traumatic tendon injuries of the hand and wrist are commonly encountered in the emergency department. This injury is usually best treated with a splint without surgery for six weeks and thereafter at night and during heavy activities for a further four weeks. They can be injured … In terms of flex or give, ligaments have the least, tendons … These injuries are classified according to the system of Leddy and Packer 11 based on the degree of retraction. motion of the finger after a tendon injury, therapy will be helpful in softening scars and building grip strength. These tendons are attached to muscles in the forearm. Results. If left untreated, the tendon usually begins to contract back into the forearm over the course of 3 to 5 days. Clinics in orthopedic surgery. A sprain occurs when a ligament in the finger, hand, or wrist stretches, but doesn’t tear. There are several factors that can increase the risk for … The tendons on the back of the hand are know as the extensors and those that bend the fingers are called the flexor tendons. Dr. Knight knows how important it is to restore to you the best possible use of your hands, and so will bring his considerable experience to bear in every case. A series of surrounding circumstances make flexor tendon injuries very complicated: For once flexor tendon injuries of the forearm or the hand typically occur close to important nerves and blood vessels, which many times get injured as well. Severe tendon injuries may require surgery. Anything from minor cuts to major hand trauma can result in injury to these tendons. Common Tendon Injuries in the Hand. When you bend your fingers, you’re using flexor muscles that start at the elbow … Therefore, an emergency department doctor may clean and close a hand laceration, then recommend tendon repair to a specialist at a later date. What is an extensor tendon? The key to diagnosing an extensor tendon injury is to maintain a high index of suspicion. multiple tendon injuries. Causes of Tendon Injury … Patients were divided into 2 groups: a … from the American Society for Surgery of the Hand . Sprains. I should've known the previous pics were too graphic, but I guess I'm desensitized after being in surgery for so many years. 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. 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. Common soft tissue conditions in the hand include trigger finger (finger tendon pain) and De Quervain's Tenosynovitis (thumb tendon pain). ↑ 8.0 8.1 de Jong JP, Nguyen JT, Sonnema AJ, Nguyen EC, Amadio PC, Moran SL. When a muscle or tendon as been overstretched, the result is a strain. Twisting? 53 flexor tendons were injured (average 1.5 digits per patient … Flexor tendon injuries in children J Hand Surg Br. Slash-type injuries can also cut tendons, but are not as common. It can happen when one player grabs another's jersey and a finger (usually the ring finger) gets caught and pulled. The tendons on the back of the hand are know as the extensors and those that bend the fingers are called the flexor tendons. In a further 5% of repairs, the tendon sticks down, and an operation called a tenolysis is required to free the tendon after a certain amount of months following the original surgery. In this case, we take the extra index finger tendon … Methods: We performed a retrospective population-based … Having said that, there may be orthopedic surgeons or even some neurosurgeons who are capable of repairing tendon injuries of the hand. Despite the frequency, few studies have examined the true incidence of acute traumatic tendon injuries in the hand and wrist or compared the incidences of both extensor and flexor tendon injuries. Tendon damage can also cause pain and inflammation (swelling) in your hand… The long thumb extensor tendon is the most common site of rupture. In this case, we take the extra index finger tendon … 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. He hopes to help you navigate the treacherous waters of modern healthcare. Injuries to the flexor tendons of the hand can be particularly challenging. Tendons produce movement of the finger joints by transmitting force from the muscle to the bone. Dynamic splintage and controlled active … 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. Tendon injuries tend to be stab-type injuries, which is why the bagel cutter injury is so prevalent. Figure 2: When flexor tendons are completely cut, the finger cannot be bent. Causes of Tendon Injury … The information here is sourced well and enriched with great visual photo and video illustrations. Tendon injuries tend to be stab-type injuries, which is why the bagel cutter injury is so prevalent. In his many years of practice, Dr. Knight has repaired hundreds of tendon injuries, and with him, you are in good hands. The Journal of hand surgery. If your extensor tendons are damaged, you'll be unable to straighten one or more fingers. At first, I thought, "Uh, oh. Sometimes follows … Extensor tendon injuries. Splints may be used for as little as 2-3 weeks or in some instances up to 3 months. Tendons and ligaments are bands of connective tissue that help stabilize the body and allow movement. What's your opinion on bagel cutters, in which you insert the bagel into a guillotine-like device and never expose your hands to a sharp knife. This is often accompanied by pain and swelling in the affected area. The primary symptom of an inflamed or injured tendon is limited use or complete inability to move certain parts of the hand. Tendon anatomy in the hand is delicate and intricate and so is the surgery required to restore it after injury. 38 children (22 male and 16 female) with a mean age of 6.7 years were treated for flexor tendon injuries by primary suture and controlled mobilization between 1985 and 1992. Leland has been a certified surgical technologist for 29 years. You may want to consider seeing a hand surgeon and getting an xray. Partially cut tendons will most likely be asymptomatic—i.e. custom-made splints; and therapeutic exercises to restore motion and function of the hand; The physician, our senior hand therapists and patient work together as a team in order to achieve … Apply ice on your tendon for 15 to 20 minutes every hour for 48 hours or as directed. Our hands are practically always in use. Primary care for these injuries consisted in wound debridement and skin suture. This doesn't necessarily happen upon injury unless the hand is configured in such a way as to cause this "snap back" effect, or unless the fingers are flexed when the injury occurs. This prevalence of males versus female patients was also observed by Saini et al, in I hurt my right thumb at work its been three weeks andi can not open bottles if i use that hand after an few minutes it still hurts the doctor said its an sprain what i dont understand is why i cant use it like before and it still bruiesed. You may hear: Tendinitis. 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