Flexor Tendon Injuries

A deep cut on the palm side of your fingers, hand, wrist, or forearm can damage your flexor tendons, which are the tissues that help control movement in your hand. A flexor tendon injury can make it impossible to bend your fingers or thumb.

Cause

In addition to cuts on the arm, hand, or fingers, certain sports activities can cause flexor tendon injuries. These injuries often occur in football, wrestling, and rugby. “Jersey finger” is one of the most common of these sports injuries.

It can happen when one player grabs another’s jersey and a finger (usually the ring finger) gets caught and pulled. The tendon is pulled off the bone. In sports that require a lot of arm and hand strength, such as rock climbing, tendons and/or their sheaths can also be stretched or torn.

Certain health conditions (rheumatoid arthritis, for example) weaken the flexor tendons and make them more likely to tear. This can happen without warning or injury — a person may simply notice that his or her finger no longer bends, but cannot recall how it could have happened.

Symptoms

The most common signs of a flexor tendon injury include:

  • An open injury, such as a cut, on the palm side of your hand, often where the skin folds as the finger bends
  • An inability to bend one or more joints of your finger
  • Pain when your finger is bent
  • Tenderness along your finger on the palm side of your hand
  • Numbness in your fingertip

Diagnosis

It is important to see a doctor whenever the fingers are injured. This is especially true if your finger is jammed and you cannot bend or straighten your fingertip.

First Aid

When you have a serious cut to your hand or fingers:

  • Apply ice immediately.
  • Tightly wrap your hand with a clean cloth or bandage to slow down the bleeding.
  • Elevate your hand by keeping it lifted above your heart.
  • See a doctor as soon as possible.

Your doctor may first clean and treat any wounds that are not deep. You may need a tetanus shot or antibiotics to prevent infection.

Physical Examination

These standard examination tests help your doctor determine if a tendon or nerve has been injured.

During the examination, your Wisconsin Bone & Joint doctor will ask you to bend and straighten your fingers. To test your finger strength, your doctor may have you try to bend your injured finger while he or she holds the other fingers down flat.

To determine whether any nerves or blood vessels have been injured, your doctor may test your hand for sensation and blood flow to the fingers.

Additional Tests
Your doctor may also order an x-ray to see if there is any damage to the bone.

Treatment

After examining your hand, your doctor may place your hand in a splint for protection.

Tendons cannot heal unless the ends are touching, which does not occur with a complete tear. In most cases, a cut or torn tendon must be repaired by a doctor. This requires surgery.

Surgery is usually performed within 7 to 10 days after an injury. In general, the sooner surgery is performed, the better recovery will be.

If your injury is restricting blood flow to your hand or finger, your doctor will schedule an immediate surgery.

Surgical Procedure

Because tendons tear in different ways — such as straight across, at an angle, or pulled right off of the bone — there are many different methods for your surgeon to repair them. All the methods for repair, however, involve special sutures, which are stitches.

Surgery is usually performed on an outpatient basis (you may go home the day of surgery). Your doctor will apply a dressing and splint after the surgery. Many doctors use a plastic type of splint to protect the repair. Your fingers and wrist will be placed in a bent position to keep tension off the repair.

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