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Flexor Tendon Injuries (Hand)

Introduction

A flexor tendon injury occurs when the tendon is cut or ruptures.  The flexor tendons attached at the palm side of your fingers and thumbs.  They allow your finger and thumb joints to bend, grasp items, and perform fine coordinated movements.  The muscles that control these tendons are in the forearm.  Lacerations, other trauma, and rheumatoid arthritis are the primary causes of flexor tendon injuries.

Flexor tendon injuries can cause loss of movement, pain, and swelling.  Flexor tendon injuries require surgical repair.  Splinting and hand therapy rehabilitation usually follow surgical treatment.

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Anatomy

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.  Sheaths 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.
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Causes

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.
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Symptoms

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.
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Diagnosis

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 can identify bone injuries. 
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Treatment

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.
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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.  A splint will immobilize your hand to allow the flexor tendon to heal after surgery.
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Recovery

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.  Splint protection is generally required for six weeks. Healing continues for three months after repair.  Your doctor will let you know what to expect.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

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Dr. Reznick did major surgery on my right hand (carpal tunnel and 3 trigger fingers). Prior to the surgery, I could not hold a pen or write my name legibly. I was in constant pain. After the surgery, while the stitches were still in and the brace still in place, I had more flexibility in my fingers than I had before the surgery. I am six weeks out from the surgery and I continue to progress. I have more functionality and strength in my hand than I have had in the last year. I can't even see the scars on my hand. Dr. Reznick not only did a spectacular job of restoring the use of my hand, but she is a very likable person. Her staff is friendly and professional. I cannot say enough good things about this experience!

Nancy L.

via md.com

Seeing Dr. Reznick and being treated by her is like going to heaven with millions of angels. She can not only treat your hand, she treats the soul. She is the best!!!

Les D.

via healthgrades.com

Amazing visit. I can't remember the last time I spent quality time with a doctor. She explained everything to me on why I was having trigger finger issues. I have been dealing with this for some time. She nailed it on the first visit ‘cause she talks to you and listens! If you need a hand doctor you will be happy she is the one.

Anonymous

via healthgrades.com

Dr. Reznick is one of the most professional, sensitive and caring physicians I have visited. She is a teacher--patient and informative, and she made sure I understood just exactly what was necessary for my particular problems. She took care of both my left and right carpal tunnel surgeries, and I couldn't have asked for a better recovery. Everything went just as planned. She is my ‘go to’ hand doctor!

Anonymous

healthgrades.com

When I was having problems with my wrist, she guided me through every step, and always made sure I was comfortable with what she was doing. Very straightforward and trustworthy. I never doubted what she was doing and she always wants to try every technique before doing surgery to try to make you better.

Shannon C.

healthgrades.com

I recently rode 900 miles on a vibrating Harley-Davidson and did not have a single tingle in either of my hands. You do great work. Thanks for helping me.

Ed G.

Just wanted to let you know again how much I appreciated your care, expertise and skill in conducting the surgery on my hand. A job well done. Thank you.

Randall A.

My surgery went very well. My banjo and I thank you.

Kevin M.

Dr. Lisa Reznick has performed carpal tunnel surgery on both hands and has removed my basal joint from my right hand. All of my surgeries have been successful, and I now have complete use of both hands and my right thumb, which I credit to a great surgeon, good therapy, and a genuine concern for patients.

Robert

My hand is in perfect working order because of your expertise. I appreciate your genuine concern for my healing. Through the myriad of maladies my husband experienced, I became acquainted with many doctors. None even approached your level of patient care.

Trudy R.

Dr. Reznick performed surgery on my hand for ‘trigger finger’ and did a wonderful job. I’ll definitely user her again if the need ever presents itself again.

Don L.

Dr. Reznick is very to the point and no nonsense. She tells you what options there are in your treatment and advises you accordingly. I had hand surgery four years ago and it was a complete success. I actually went back to work one week early. I have recommended Dr. Reznick to many friends and associates. Frankly, I won’t go to anyone else when it comes to muscles or bones. I have complete faith in her.

J. Schully

via vitals.com

Dr. Reznick did major surgery on my right hand (carpal tunnel and 3 trigger fingers). Prior to the surgery, I could not hold a pen or write my name legibly. I was in constant pain. [Now] I have more functionality and strength in my hand than I have had in the last year. I can't even see the scars on my hand. Dr. Reznick not only did a spectacular job of restoring the use of my hand, but she is a very likable person. Her staff is friendly and professional. I cannot say enough good things about this experience!

~ Nancy L. via md.com

Lisa R. Reznick MD, PA

Board Certified Orthopedic and Hand Surgeon

4100 Fairway Court, Suite 120
Carrollton, TX 75010
Phone: (972) 395-9000
Fax: (972) 395-9002

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In Carrollton, TX, board-certified orthopedic surgeon Dr. Lisa Reznick offers conservative treatment options for all types of general orthopedic issues, while specializing in surgeries of the hand, wrist, and elbow.