Flexor Tendon Injuries

Your hand is composed of many bones that provide structure for your wrist and fingers.  Your fingers and thumbs are made up of bones called phalanges.  The bones are connected with strong ligament tissues. Tendons are strong fibers that attach your muscles to your bones and allow movement.  Your hand also contains nerves, blood vessels, and fat.

Your flexor tendons begin in your forearm and continue to the palm side of your fingers and thumb.  Each finger has two flexor tendons and your thumb has one.  They are located just underneath the skin.  A sheath thickened in areas by fibrous pulleys guide the flexor tendons and keep them close to your phalanges during motion.  The flexor tendons allow your fingers and thumbs to bend, grasp items, and perform fine coordinated movements. The nerves in your fingers(digital nerves) travel parallel and along both sides of the flexor tendons.

Deep cuts are the main cause of flexor tendon injuries.  They may also occur during sports, such as football, wrestling, rugby, and rock climbing.  Rheumatoid arthritis can cause flexor tendons to rupture. The outward injury often appears simple, but is usually complex when involving the tendons and possibly the nerves.

A flexor tendon injury can cause your finger joints to feel painful and swollen.  It may be difficult or impossible for you to move your finger. You may not be able to bend your finger joints. Nerves are located very close to the flexor tendon. If the nerves are injured, your finger may feel numb.

Your doctor can diagnose a flexor tendon injury by reviewing your medical history and examining your wrist, hand and fingers.  You should tell your doctor if you sustained an injury.  Your doctor will carefully move your finger joints.  Your doctor will test the sensation and blood flow to your fingers.  X-rays may be used to identify bone injuries.

Flexor tendon injuries do not heal well without surgical repair.  When a flexor tendon separates, the two pieces pull away from each other, making it impossible for the tendon to heal without surgery.

There are many ways to surgically repair flexor tendons.  Certain types of injuries need specific types of surgery. Your hand surgeon will stitch the ends of the tendon together and repair damaged nerves, blood vessels, or bones.  Your hand will be immobilized with a splint to allow the flexor tendon to heal after surgery.

Hand therapy rehabilitation and continued splinting follow flexor tendon repair surgery.  Hand therapy will help you regain strength, flexibility, motion, and functional use of your hand. Recovery from flexor tendon surgery is very individualized, and rarely is full normal motion regained. Therapy protocols vary, and will depend on the nature of your injury and repair. S plint protection is generally required for six weeks. Healing continues for three months after repair. Y our doctor will let you know what to expect.