Flexor Tendon Injuries

Information for patients

NHS Lanarkshire Hand Therapy Department

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Introduction

You have injured the flexor tendons, which bend your fingers. The tendons are very delicate after surgery and without proper rehabilitation the repaired tendon could rupture. Rupture of the tendons would require further surgery and delay the healing process.

Tendons take up to twelve weeks to heal and during this time your activities will be restricted. Heavy lifting and contact sports should not be carried out until after twelve weeks. You are advised to discuss your return to work with your hand therapist. If you drive to work this will not be permitted straight after surgery. Your work activities will dictate when you are permitted to return to work.

Elevate your hand for the first two weeks after your operation to reduce swelling. Use a sling or rest your hand on your shoulder or on pillows when you sleep. Letting your hand hang down may cause it to throb and become swollen.

Your tendons will need to be protected in a thermoplastic splint to prevent certain movements and activity that will risk rupturing your tendon repair.

Wear your splint 24 hours a day for the first 6 weeks.

Then for a further 2 weeks at night time.

You are not permitted to drive at this stage.

Splint care

Do not place your splint in hot water or near a heater.

Check your skin regularly for red, sore areas of skin and let your therapist know if you have any concerns.

Use a plastic bag to cover your arm and splint when showering or bathing until your therapist advises that you may complete a protected bathing of your hand. This means you can wash your hand carefully in a wash basin or in the bath, without using it.

General Care to Your Hand

Do not attempt to fully straighten your finger(s) with your other hand.
Do not use your injured hand for anything. Any activity other than supervised exercises may cause your tendon(s) to rupture. This includes even the lightest of tasks e.g. housework, driving.
Do not get your hand or splint wet whilst stitches are present. If showering or bathing place your arm in a polythene bag to keep it dry.
It is extremely important you do your exercises regularly and exactly as prescribed.
Do wear your sling if out in public to protect and raise your injured hand.

Scar Care

After surgery it is important that you keep the dressing dry to avoid problems with your wound. Your stitches will be removed 10-14 days after the surgery.

Once your wound is fully healed massaging the scar helps to keep the tissues around the tendon supple and mobile, this will make it easier for you to move your hand. Your hand therapist will show you how to do this.

Home Exercise Programme: Week 1

These exercises are to help keep your injured hand supple and move the injured tendon(s), improving their function and strength. If you do not move at all then your tendons may become stuck in scar tissue, causing contractures of the joints. Remove your arm from the sling, stretch above your head, straightening your elbow.

Without forcing movement, use your unaffected hand and push all fingers into the palm, pressing gently over the nails and try to keep the fingertips in contact with the palm using your forearm muscles.

Actively bend your fingers into your palm gently. Try to initiate the movement with the tips of the fingers first

Actively straighten your fingers to the back of the splint, concentrating on touching the splint with your fingernails. Do not force the fingers straight with your uninjured hand.

Repeat all exercises 10 times every hour

Week 6 – Week 8

Your tendon is now a little stronger but is still at risk of rupture if you use your hand for heavy tasks. The second half of your tendon rehabilitation is meant to gradually increase the strength of the tendon.

Continue to wear the splint at night and when outdoors.

Start to use your hand for light activities, less than 1kg in weight, e.g. hold your mobile phone or a light cup or newspaper etc.

Squeezing a firm stress ball is NOT advised at this stage.