Flexor and Extensor Tendon Laceration

What is flexor and extensor tendon laceration?

The flexor tendons are located on the palm-side of the fingers and attach the flexor muscles to the finger bones, enabling the finger to be flexed into the palm for grasping and gripping. Extensor tendons are on the top side of fingers and help the digits to straighten, grasp and let go of objects. Laceration to any of these tendons resulting from an injury caused by a knife or glass can cause pain, loss of function and damage to surrounding tissue. The injury can partially sever the tendons, in which fingers can still move, or completely cut the flexor or extensor tendons, causing total loss of mobility in affected fingers for a given direction of motion (bending vs. straightening). Due to complications with finger lacerations, and urgency for rapid surgical repair in almost all cases, it is critical to have a careful evaluation by a physician specializing in conditions of the hand right away to receive the best possible treatment. The physicians at Midwest Orthopaedics at Rush Hand, Wrist & Elbow Institute are using cutting edge surgical procedures to treat lacerations.

What are the symptoms of flexor and extensor tendon laceration?

Symptoms of flexor or extensor tendon laceration are usually easy to identify because it causes sudden immobility of a given finger. The following are common signs:

  • Open injury on the hand, such as a cut
  • Inability to independently bend or straighten a joint or finger
  • Pain when bending finger
  • Numbness of a finger can suggest a combined tendon and nerve injury

Who is likely to get flexor tendon or extensor tendon laceration?

Flexor tendon and extensor tendon laceration can happen to anyone who sustains a penetrating injury to the hand, wrist or arm. Deep cuts to the hand are most common causes. Some conditions, such as rheumatoid arthritis, can weaken the tendons, making them more susceptible to spontaneous rupture. Athletes are also at higher risk for flexor tendon injury.

What causes flexor and extensor tendon laceration?

Flexor tendon and extensor tendon lacerations are usually caused by an injury to the finger, hand or arm. Cuts to these areas can cause simple-looking injuries that may have actually done extensive damage to the intricate groups of tendons, nerves and blood vessels that are critical to proper hand function. Careful evaluation is needed to avoid permanent damage, especially in deep finger cuts. Some athletic activities can cause lacerations, such as wrestling or playing football. Some conditions, such as rheumatoid arthritis, can weaken the tendons, making them prone to tears. Often when the tendon is partially torn, it will eventually completely tear. For complete tendon tears, surgery is almost inevitable as the torn tendon ends pull away from each other at the tear and cannot heal back together on their own.

How are flexor and extensor tendon lacerations diagnosed?

Flexor and extensor tendon lacerations are diagnosed through a careful examination by an orthopedic surgeon specializing in the hand. He or she will check for visible cuts, swelling, bruising and flexibility of fingers. An X-ray may be ordered to ensure no damage was sustained to the bones.

What are the treatments for flexor or extensor tendon lacerations?

Non-surgical Treatment Options

  • Splint
  • Ice to affected area
  • Anti-inflammatory and pain reducing drugs, such as ibuprofen

The vast majority of tendon lacerations are surgical injuries to allow repair of the cut tendon(s). Splints, ice, and anti-inflammatories are useful pre-operatively for comfort and soft tissue healing, but except for partial lacerations these are not definitive treatments.

Surgical Treatment Options

Physicians at the Midwest Orthopaedics at Rush Hand, Wrist & Elbow Institute, who perform surgery at Rush University Medical Center, Chicago, and at Rush Oak Park Hospital, perform minimally invasive surgery to suture the tendon together. The tears may be straight across the tendon, cut at an angle or pulled off the bone. In some cases, the ends of the tendon can be sutured together or a suture is made directly to the bone. Surgery should be performed as soon as possible after injury to ensure successful results. Post-surgery, a cast or splint is needed for typically six weeks to protect the tendon repair. Healing may take up to three months for full recovery and function.

Since the treatment of lacerations is so critical to future use of the hands and fingers, physicians at the MOR Hand, Wrist & Elbow Institute will carefully evaluate the condition, lifestyle and occupation of the patients before discussing the best surgical treatment on a case-by-case basis.