Reconstructive surgery of the hand tendons

Tendons are the noble structures that connect the muscles and the bones, allowing for the muscle contraction to turn into movement in the anatomical segments. The hand is the anatomic segment with the most tendons, which are directly involved in finger movements. (see Image 1)

Trauma to the tendon can occur in the following circumstances:

  • accidental cuts (glass, knife, sword etc)
  • accidents in the household
  • work injuries while using electric shearing machinery (flex, jointer, circular etc)
  • important bruises or tears etc.

The hand tendon repair is done depending on the complexity of the injury and the degree of pollution of the wound, with immediate emergency (in the first hours after the accident), in delayed emergency (the first 24-72 hours after the injury) or in secondary delayed emergency (within 2 weeks from the injury). 

If more than 3 months have passed after the injury, tendon reconstruction methods are already taken into account. These methods often involve tendon stretching or remodeling (called tenoplasty), tendon release from posttraumatic scars (called tenolysis), or tendon grafts, often being used the long palmar tendon, a tendon from the volar side of the forearm that can be sacrificed without notable pathological implications.

In the case of immediate repair, the techniques differ depending on the location of the injury. Flexor tendons (in the palm of the hand) that are force tendons require a special suture technique in order to hold the stress of finger movements and motions of gripping and lifting of objects of different masses.

In the case of extensor tendons lesions (those on the dorsal hand) sometimes they can heal without suturing, only splint immobilization in a cast beeing necesary for 3 weeks.

Results depend largely on the type of injury, its severity and the time lapsed since its appearance.

Suna Acum