The muscles that bend (flex) or straighten (extend) the
fingers, thumb and wrist originate in the forearm and are called either the
flexor or extensor group of muscles.
Each muscle has a long sinew like chord called
a tendon that attaches it to the finger/thumb or to the carpal bones in the
wrist. When a muscle contracts it tugs
on the tendon producing movement in the digit it is attached to.
Trauma to the
hand and forearm such as deep cuts, displaced
fractures and crush injuries can sever
through one or more tendons. As a result, it is impossible to perform movement
by that muscle.
If you attend A&E the doctor will ask you to perform certain movements with your fingers and thumb. If you are unable to move them in certain directions it is reasonable to assume your tendon has been cut and will need internal stitches to repair it.
Even an injury that looks small on the outside can be much more complex beneath the surface as cut or partially cut tendons can recoil back up the arm and must have surgery to stitch them back together or they cannot heal. X-rays may be performed to rule out
fractures that may have happened at the time of the injury.
After surgery, the person will need to wear a splint on their hand and wrist to prevent over stretching the tendons as they can easily tear apart again if the stitches are strained too soon.
Usually 1 or 2 days after surgery the persons hand is removed form the heavy cast made in theatre. Your Hand therapist will make a light weight splint designed to facilitate gentle movement of the repaired tendons.
Successful outcomes are largely determined by the compliance of the person in performing these exercises as instructed by the Hand therapist and the skill of the therapist in progressing treatment when appropriate and safe to do so.
In the beginning the patient will be asked to remove the straps from their splint to be able to freely perform gentle passive movements to the affected fingers/thumb.
"Passive" means the other hand does the exercise to the injured hand. After a number of weeks the tendon can begin moving by itself, and later the splint is removed entirely so light activities can begin.
Unfortunately you will not be insured or able to drive safely while your tendon is repairing and you are wearing a splint. You will need a friend or family member to take you to clinic appointments in hospital but if you have difficulty with this and would prefer local treatment or flexible treatment times, then Hand Kinetics can help you.
At Hand Kinetics our therapists are trained to treat and rehabilitate your tendon repair using specific guiding protocols following surgery which can take several weeks wearing a splint.
Once it is safe to use your hand for everyday activities you may feel your hand would continue to benefit from rehabilitation. At Hand Kinetics we have a specific hand gym for improving strength in the tendons and encouraging greater range of movement.
It is common to have a scar following a tendon repair and it is very important to look after it so that it doesn't tether on normal skin or muscles and tendons beneath the surface.
Troublesome scars need their own kind of treatment. We can show you how to correctly perform scar care so that repairing tissue heals as flat and as small as possible.
Please note:
If you have had arm or hand surgery please telephone to discuss this before attending. It is always helpful to bring any reports you may have if you recently attended hospital for your hand or arm condition.
Hand Kinetics Telephone: 0044 28 417 72301
www.handkinetics.com
contactus@handkinetics.com
