Flexor 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 flexor tendons are damaged you will not be able to bend one or more of your fingers.

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. Flexor tendons are often difficult to get to and are located near important nerves so repair will generally occur under a general anaesthetic.

Procedure Goals

The goal of flexor tendon repair is to achieve normal range of motion of the finger or thumb. The surgical approach depends on the level of injury.

Risks of the Procedure

General complications include infection and tendon rupture.

What to Expect

After Procedure

After surgery, the hand may be brusied and swollen, and you will most likely experience pain as the anaesthetic 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. Individual healing times may vary, depending on a range of factors, including the patient’s age, general health and the level of scar formation.

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

Your return to work and resuming daily activities depends on the nature of your job, and the site of your injury. Most light activities can usually be resumed after six to eight weeks, and heavier tasks and sports activities after six months. Your surgeon can provide you with a more accurate estimate of your expected recovery period.

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

An occupational therapy program, supervised by a professional hand therapist, may be recommended, in order to accelerate the healing process and give you the best chance for a complete recovery. Therapy may include exercise, massage therapy, and specialized bandages to control swelling. It is important to complete the entire rehab course and to follow your therapist’s instruction in order to obtain maximum use of your hand and arm. Attempts to use the repaired tendons beyond their capacity during the healing period, can cause them to split apart.