Tendon Injuries

Anatomy
Flexor tendon Z Tendons are the anatomical component that joins muscle to bone. Tendon injuries are the second most common hand injury following fractures. Tendon injuries may be differentiated as ‘open’ injuries, whereby the tendon has been lacerated, or ‘closed’ injuries, which may occur with crush injuries, avulsion fractures (when a small fragment of bone attached to a tendon gets pulled away from the main mass of a bone), or in the presence of degenerative conditions.

Common Injuries
Common closed tendon injuries include ‘mallet finger’ or ‘boutonniere deformity’. Injuries may occur to the flexor tendons (palmar surface of the hand and forearm) or extensor tendons (back of the hand or forearm). Tendon injuries are further classified by zones. Each zone of injury has different treatment protocols and prognostic indications.

Diagnosis
Diagnosis of a tendon injury is particularly important, as some incomplete injuries may initially be difficult to diagnose. Other structures such as nerves and blood vessels are also commonly injured during open tendon injuries.Flexor tendon Z

Rehabilitation
Following a surgical repair of a tendon, there will be very specific guidelines to adhere to during your rehabilitation. There are 3 phases of tendon healing. The first is the ‘inflammatory’ phase, which lasts for approximately the first 7 days following surgery. The second phase is the ‘fibroblastic’ phase, where new cells are being formed, and is from approximately day 7 to 21. During this stage it is only the suture material that is holding your tendon repair together and there is a higher risk of rupture or gapping occurring. The third stage is the ‘remodeling’ phase, where collagen fibres are being aligned, there is an increase in scar production, and at 8 weeks the tendon is much stronger. The whole healing timeframe for a tendon repair is approximately 12 weeks. It is best practice to see your hand therapist on a weekly basis during the initial phases of treatment to prevent further complications.

Following a tendon repair, an orthosis will be fabricated by your therapist at Hand Works, and it will be worn for approximately 6 weeks. Your hand therapist will gradually give you more exercises to complete each week, which are in line with the healing phases of tendon tissue. It is common to get complications following a tendon repair. Some common complications include scar adhesion, joint stiffness and movement limitation. At Hand Works, our staff are well trained at working specifically on issues such as these to ensure that you get the best clinical outcome following a tendon injury.