Tendon injuries

The tendons of the hand are essential structures that enable flexion and extension of the fingers. Whether traumatic or degenerative, tendon injuries require early diagnosis and appropriate treatment to restore full hand function.

Types of tendon injuries

• Acute ruptures: caused by lacerations (glass, knife) or avulsions (the tendon is torn from its bony insertion)
• Tendinitis: inflammation of the tendon due to overuse or repetitive movements
• Tenosynovitis: inflammation of the sheath surrounding the tendon (including de Quervain disease)
• Chronic ruptures: secondary to degenerative wear, rheumatoid arthritis or other conditions

Symptoms

• Inability to bend or straighten a finger (in the case of a complete rupture)
• Localised pain that worsens with movement
• Swelling and crepitus over the affected tendon
• Loss of grip strength when grasping objects

Diagnosis

Clinical examination can identify which tendon is affected. Ultrasound and MRI are valuable for confirming the diagnosis and planning treatment, particularly in partial or chronic injuries.

Treatment

Acute flexor and extensor tendon ruptures require early surgical repair, ideally within the first few weeks. Surgery involves suturing the tendon ends using specialised techniques. Tendinitis and inflammatory conditions usually respond to non-surgical management: rest, splinting, anti-inflammatory medication and rehabilitation.

Rehabilitation

Rehabilitation is a cornerstone of tendon injury management. Early controlled mobilisation protocols are commenced to promote tendon healing whilst preventing adhesion formation. Recovery time is variable and depends on the type of injury, the tendon involved and individual response. In some cases, secondary surgeries may be necessary to improve the functional outcome.