Hands play a very important role in our lives. Especially for those people who use their hands are part of their profession. When connective tissues like tendons are injured or suffer from repetitive stress it can affect your fine dexterity in a way that can go beyond hampering your quality of life.
There are many tendons in the human body. Though the tendons in the hands are some of the most important when it comes to accomplishing essential daily tasks. On a basic level, tendons are tough cords of tissue they differ slightly from ligaments in that they connect muscles to bones. This means that anytime a related group of muscles contracts that the attached tendons will pull the related certain bones. In the case of the tendons in the hands, this allows you to create a wide range of motion with your fingers, palm, and even the wrist.
The Different Types Of Hand Tendons
When it comes to the hands, tendons can further be broken down into two groups, based on their function and motion.
Extensor Tendons
These connective tissues essentially run from the forearm, across the back of the hand to the fingers as well as the thumb. Extensor tendons give you the ability to do things like straightening your fingers and your thumb.
Flexor Tendons
They run from the forearm, through the wrist, and across the palm of the hand. Flexor Tendons make it possible for you do to things like bending your fingers.
When repetitive stress, chronic inflammation, or injuries affect the extensor or flexor tendons of the hands it can have a major impact on your dexterity as well as your overall quality of life.
Common Causes Of Hand Tendon Problems
The following are some of the more common causes of hand tendon injuries.
Cuts & Lacerations
Cuts, large puncture wounds, and deep lacerations on the back of the palm of the hand can cause severe tendon injury. Even a cut that only partially damages a tendon, while still leave it intact can have a major impact on the functionality and dexterity of the affected hand.
Sports Injuries
Athletics can place an extreme stain on many body parts, especially the extensor tendons of the hands. Sometimes something as seemingly simple as “Jamming” a finger can rupture an extensor tendon. This could come from a basketball rebound or catching a football pass. On the other end of the spectrum. A hard blow to the hands and fingers can potentially stretch flexor tendons beyond their limits causing the attachment to be pulled off the bone. This same risk is posed by extreme feats of grip strength like rock climbing or pulling on ropes.
Animal Bites
People who work with animals like veterinarians, farmers, and animal shelter workers are often at high risk for bite injuries on the hands. When teeth tear into the flesh it can potentially puncture, or sever flexor or extensor tends in the hands.
Crushing Injuries
Things like accidentally dropping a heavy object on the hands, or accidentally slamming a hand in a car door can cause severe damage or even rupture a flexor or extensor tendon in the hands.
Chronic Rheumatoid Arthritis
The deep inflammation caused by rheumatoid arthritis can swell and hard tendons to the point of rupturing. In some of these cases, the chronic inflammation weakens the integrity of the hand tends to the point where a modest amount of force ruptures a flexor or extensor tendon. This is even more likely to be the case when it comes to repetitive motions.
When Is Hand Tendon Surgery Needed?
With some hand injuries, the damage or inflammation to the tendon can be addressed via rest, anti-inflammatory medications, and perhaps physical therapy. Though a case where a flexor or extensor tendon is ruptured, severed, or partially cut to the point that it limits the range of motion in the hands, surgical intervention is often required.
Signs Of A Damaged Extensor Tendon In The Hands
When an extensor tendon in a hand is damaged it often presents as an inability to straighten one or more fingers. Localized swelling is often a problem near the point of the rupture or laceration.
Signs Of A Damaged Flexor Tendon In The Hands
In the case of a damaged flexor tendon, the individual will typically be unable to bend one or more fingers. Localized swelling is often a problem near the point of the rupture or laceration.
How Is Hand Tendon Repair Surgery Performed?
Most hand tendon surgeries are performed on an outpatient basis. Some can be done with just an injection of local anesthetic. Though in the case of a longer repair, your physician might recommend full sedation for your comfort.
The surgical treatment process starts with your surgeon making a careful incision in your wrist, hand, or the affected finger. This will give them access to the damaged ends of the damaged tendon.
At that point, the ends of the compromised hand tendon will be carefully stitched together by an orthopedic surgeon who specializes in hand surgery.
In general, an extensor tendon is easier to access which makes it easier to repair ruptures and lacerations. However, flexor tendons tend to be a little more challenging to surgically repair and typically require longer periods of recovery as well as physical therapy. Most flexor tendon repairs require full sedation.
Post-Operative Recovery After Hand Tendon Surgery
The rehabilitation process can vary depending on the type of tendon that was repaired. In general, flexor tendons take longer to fully heal and rehabilitate the repaired extensor tendons.
After surgery, the incision site will be sutured or stapled, and your hands will be placed in a special hand splint. The splint will need to be worn for several weeks up to a month after tendon repair surgery.
Your physician will give you some basic hand exercises to before daily during the early days of recovery after hand surgery. You will likely be referred to a physical therapist who will develop an effective rehabilitation strategy.
Most people can resume light duty with their hands after roughly 6 to 8 weeks after surgically repairing the tendons. Most individuals are cleared for more heavy activities and sports after 10 to 12 weeks. In general flexor tendon repairs take longer to fully recover from than extensor tendon repairs.