Tendon Injury and Tendon Rupture
Dr. Steven Rueda is one of the most sought after doctors for treatment of tendon injury in Palm Beach. These injuries most commonly result after sharp cuts and disrupt the continuity of the tendons. Tendons originate from muscles and insert in bone leading to movement of the joints. Injury to the tendon leads to absence or weakness of voluntary movement at finger and hand joints.
Tendon Injury and Tendon Rupture Symptoms and Diagnosis
The symptoms arising from tendon injury are mostly mechanical. Since the tendon is no longer intact, the movement it provides is weakened or absent. In partial tendon tears, there is still movement but with some associated weakness. Pain at the site of injury is also common. Some of the most common symptoms include:
- Inability to move joints in the finger, hand, or wrist
- Weakness while moving the finger, hand, or wrist
- Pain, clicking, or catching while moving the finger, hand, or wrist
The diagnosis of tendon rupture is usually performed by clinical examination and history. In some cases, advanced imaging like Ultrasound or MRI may be necessary if the tendon rupture occurred without trauma to evaluate any internal causes.
WHAT CAUSES Tendon Injury and Tendon Rupture?
Tendons are divided into two main types: flexor tendons and extensor tendons. Flexor tendons are those that are present on the palm side of the hand, wrist, and forearm. Extensor tendons refers to those that are present on the back of the hand, wrist and forearm. The main goal of tendon injury treatment is to repair the tendon and reestablish its function.
Tendon rehabilitation after trauma is challenging, in particular for injuries to the flexor tendons at the level of the fingers. These tendons pass through tight tunnels called pulleys that control their direction of glide. After injury and repair, scarring can make it difficult for tendons to glide in the tight tunnel.
Tendon Injury and Tendon Rupture Treatment Options
Tendon injury treatment is very important to reestablish function of the hand and wrist. Treatment varies depending on the type of tendon injury: full rupture or partial rupture. Full tendon ruptures are repaired with surgery using sutures to bring the tendon ends together. Partial ruptures are usually also treated surgically to prevent the weakened tendon from becoming a full rupture. Very small partial tears can usually be left alone.
Although tendon repair is very straight forward, the rehabilitation needed to regain normal tendon movement is the most challenging of the entire process. The most common problem after tendon repairs is scarring around the tendon that limits its glide and function. Rehabilitation focuses on moving the tendon to prevent it from scarring down, yet at the same time not moving it too much to avoid rupturing the repair. This is particularly difficult to accomplish in the flexor tendons since they travel through a very tight tunnel.
Tendon Injury and Tendon Rupture Procedure
Tendon ruptures are treated with surgery in the great majority of cases.
Incisions for tendon ruptures are made in the back or the front of the hand or wrist. The length of the incisions is highly variable as it depends in the area the tendons were cut, if there has been tendon retraction, or if tendon grafts are needed. Dr. Rueda discusses the details of the incisions with each patient prior to every surgery. It is common practice to enlarge the laceration that caused the tendon damage to find the cut edges of the tendons and repair them back to their original site.
RECOVERY AND DOWNTIME
A splint is worn after surgery for about 1-2 weeks. The sutures are then removed and a removable splint is then worn for the following 6-8 weeks. Therapy is started as soon as the splint is removed in the first or second week and is continued for at least 3 months.
The downtime is dependent on the type of tendon injury but also on patient occupation. In some cases patients return to work after 1-2 week if they can work with a splint. In any case, any activity that may cause further injury to the tendon is avoided until it is fully healed. It may take at least 6-8 weeks for the tendon to be fully healed and to resume normal activity.
Why Choose Precision Hand Center for your Tendon Injury and Tendon Rupture Procedure?
Dr. Rueda, a Hand Fellowship trained surgeon who has 7 years and 2,000 procedures of experience will be your safe and best choice for tendon injury treatment. Successful results in these procedures require a surgeon that is experienced and knowledgeable in hand surgery and hand anatomy. Dr. Rueda has published articles in expert peer reviewed journals and his work has been presented in several national conferences. Dr. Rueda’s passion for patient education and custom centered approach will guarantee you feel comfortable every step of the way. Dr. Rueda also believes in treating his patients as if he was treating his own family; you can trust you will enter a trusting and long-term relationship and have some of the best tendon injury treatment Palm Beach can offer.
FREQUENTLY ASKED QUESTIONS (FAQ)
No! It is important to see the Hand Surgeon within the first week of the injury. If more than 2 weeks pass by there is a high chance of the tendon ends shortening making repair impossible. In these cases the patient must undergo a very complex process of tendon reconstruction. This implies that tendon has to be borrowed from somewhere else in the body to repair the originally cut tendon; this procedure usually requires 2 surgeries and is very taxing on the patient.
The goal of the surgery is to return function back to normal and this can be achieved in some patients. However, it is common to have some residual stiffness after the procedure and after undergoing full therapy and recovery. In these cases, other procedures to release the scar from the joints and the tendons may be needed to enhance function.