Flexor tendon injury – treatment

Ideally, such a direct suture is performed in the first 48 hours after the injury. However, it can also be successful within the first two to three weeks after the trauma. After more than four weeks, direct suturing is often no longer possible because the tendon ends have degenerated. In these cases, a tendon reconstruction is necessary in which the defective area in the tendon is bridged or replaced. Either tendons taken from elsewhere on the body can be used or other tendons can be transferred to the affected finger.

Which variant is more suitable must be determined for each individual case. If the digital canal has been destroyed as a result of a flexor tendon injury or infection/inflammation, it must first be reconstructed before the tendon can be reconstructed. In these cases, a temporary tendon replacement in the form of a silicone rod is inserted. This allows a new lubricating layer to form and the reconstructed digital canal to heal over a period of six to eight weeks. In a second operation, the silicone rod is removed again and the tendon reconstruction is performed.

Aftercare

Correct and consistent follow-up treatment is of immense importance. On the one hand, the sutured tendon should be moved as quickly as possible after the operation to prevent adhesions from forming. On the other hand, do not apply too much force to the suture so that it can heal and does not tear. To achieve this, various splints and intensive hand therapy are required.

Even with well-performed surgery and follow-up treatment, tendon adhesions can occur, especially if the injury was in the course of the digital canal. In these cases, it may be necessary to perform a second operation after 6 months to loosen these adhesions (tenolysis). Following tenolysis, hand therapy is required twice a day for two weeks to prevent new adhesions.