Flexor Tendon Injuries

Flexor tendons are cord-like structures running from the forearm across the wrist and palm and into the fingers, allowing you to bend your fingers and thumb to grasp an object or make a fist. Like a rubber band, the flexor tendons are under tension as they connect the muscle to the bone. Injuries to the flexor tendons can cause you to lose the ability to bend one or more of the joints in your hand.

How can a flexor tendon get injured?

Flexor tendons can be injured when a finger or thumb is violently pulled away from you while you are attempting to grasp something, such as the jersey of an opposing player in sports. While an open cut may cause a tendon laceration.

In activities that require a lot of a hand strength (e.g., rock climbing), tendons and/or their sheaths can also be stretched or torn. The crimp-grip position of the fingers necessary for rock climbing places a great deal of strain on the pulleys of the tendon sheath and can cause a rupture of the sheath. When this occurs, it can limit how much the finger can bend or flex and can cause pain when moving the finger.

Certain health conditions, such as rheumatoid arthritis, can weaken the flexor tendons and make them more likely to tear or rupture. This can happen without warning or injury — a person may simply notice that their finger no longer bends but not recall how it happened.

It is important to see a doctor whenever the fingers are injured — especially for an open injury or cut in the skin.

The most common signs of a flexor tendon injury include:

· An open injury, such as a cut, on the palm side of your hand, wrist, or forearm

· An inability to bend one or more joints of your finger

· Pain when you attempt to bend your finger

· Tenderness along your finger on the palm side of your hand

· Numbness in your fingertip

How is the injury treated?

Partially torn tendons may not require surgery for good results. The same splinting and exercise programs that are used for surgery patients can be very effective for patients with partial tears. A nonsurgical treatment option is appropriate only after the doctor has assessed the extent of the injury.

Tendons cannot heal unless the ends are touching. In most cases, a cut or torn tendon must be repaired by a surgeon. If a flexor tendon is completely torn, a surgeon will use special sutures or stitches to make the repair. After surgery, a splint is applied to limit movement and help the tendon heal.

What is the recovery prognosis?

Advanced research and experience in the treatment of flexor tendon injuries have resulted in improved patient outcomes. Flexor tendon injuries can be very challenging to treat. Patients may develop stiffness and poor function of a digit after flexor tendon injury and repair.

For this reason, it is very important to be seen promptly if you are concerned you may have a flexor tendon injury. It is also essential to work with therapy and follow all instructions after you undergo a flexor tendon repair to optimize your outcome.

Overall, despite its challenges, flexor tendon surgery results in good return of function and high patient satisfaction for many patients.