Extensor Tendon Repair

What is it?

Tendon repair is necessary when one or more tendons in the hand are divided or ruptured which leads to a loss of normal hand movements. If the extensor tendons are damaged you will not be able to straighten one or more of your fingers. Extensor tendons are found close to the surface of the skin of the forearm and the hand, making them particularly susceptible to injuries, lacerations, and burns.

What are the treatment options?

Surgery will be required in order to repair the damaged tendon. A small incision is made to locate the ends of the tendon and they are then stitched back together. Because extensor tendons are easy to reach they are relatively easy to repair. Depending on the injury, it is possible to have this procedure performed under a local anesthetic.

Procedure Goals

The goal in any extensor tendon repair surgery is to reestablish the integrity and durability of the damaged tendon, thereby renewing as much of previous function as possible

Risks of the Procedure

General complications include infection and tendon rupture.

What to Expect

After Procedure

After surgery, the hand may be bruised and swollen, and you will most likely experience pain as the anesthetic wears off. The repaired tendons are going to be very weak until completely healed which can make recovery a lengthy process. Depending on the location recovery may take anywhere from 1 to 3 months.

Before you leave the surgery center, your hand will be placed in a rigid hand/wrist splint that prevents the repaired tendon from being overstretched. You will wear the splint at all times for the first four weeks.

Discharge Instructions

Diet

You may resume your regular diet. However, start slow with clear liquids and gradually work your way back to your normal diet. This will help prevent nausea and vomiting.

Hand Care & Bathing

Keep your dressing and splint in place until your first post-op visit
Dressing will be changed at your first post-op appointment
Tegaderm dressing will be placed which will allow you to shower immediately
No bath or swimming until the bandages are removed
If the tegaderm dressings become loose or fall off replace with over the counter water proof bandages
Keep incision dry until sutures are removed.

Elevation and Circulation

Elevate the extremity on pillows with fingers point toward the ceiling as much as possible for the first 3-5 days.
After these first few days, continue to elevate as needed in order to reduce swelling.

Cold Therapy

To help reduce pain and swelling, apply an ice pack to the surgical area for 20 to 25 minutes every one to two hours for the first 48 hours and then as needed to help control pain and swelling.
To avoid frostbite, place a towel or t-shirt between the ice pack and your skin.
It is not necessary to use ice while sleeping.
We recommend the use of a cold therapy unit, which is often an out of pocket expense. The advantage of this unit is that the temperature can be regulated, allowing for continuous use for several hours at a time.

Pain Medication

Your physician will give you a written prescription for pain medicine as you leave the surgery center. Take your pain medication as prescribed. You may want to take it regularly for the first 48 hours after surgery. Do not take any additional Tylenol.
While you are asleep in the operating room, a long acting numbing medication may be injected into the surgical area to help relieve your immediate postoperative discomfort for up to 24 hours. When you first notice tingling or throbbing, begin taking your pain medicine so it will become effective before the local anesthesia wears off.
No driving while taking any narcotic pain medication!
The pain medication may cause some nausea so take it with food.
The pain medication and general anesthesia may also cause constipation, so you may need to take a stool softener, fiber bar, Metamucil or prune juice to prevent constipation.

Follow-up Care

Watch for temperature > 101.5F, persistent numbness and tingling, persistent bleeding or drainage from the wound, foul odor, progressively worsening pain that is unresponsive to pain medication, chest pain or difficulty breathing. If you have any of these symptoms, call the office if during normal business hours or go to the nearest emergency room.
Please make sure to follow instructions given to you by your physician, they may have specific instructions to your care.
If you do not have a postoperative appointment set-up already, please call the office to schedule an appointment for 7-10 days after surgery at (785)843-9125.

Rehabilitation Plan - Exercises

You will be prescribed occupational therapy after your surgery to restore your range of motion. An occupational therapist will teach you exercises that will keep the tendon moving so that it does not get stuck to the surrounding tissue.

You will be placed in a splint that is to be worn at all times for the first four to six weeks, except for when doing the exercises given to you by your therapist. At six weeks, your splint may be removed for light ADL’s but you will continue to have a lifting restriction of five pounds. At seven weeks, you can start weaning out of the splint for one hour at a time and at 12 weeks, you may discontinue use of your night splint.