Our Summary

This research paper is about the challenges faced in treating injuries to the flexor tendons in the hand, which are the tendons that help us flex or bend our fingers. Even with careful repair, these tendons often end up sticking or adhering to each other, causing complications. The paper talks about the progress that has been made in understanding how these tendons heal and why they stick together, but admits that progress in preventing or reversing this sticking problem in patients is slow.

The paper suggests that more research is needed to understand the specific biological and genetic processes involved in how these tendons develop, heal after surgery, and respond to physical stress. This knowledge is important to help improve surgical outcomes and develop new treatments to encourage the growth of healthy tissue and prevent the tendons from sticking together.

FAQs

  1. What is the main issue with the management of flexor tendon injuries of the hand?
  2. What progress has been made in understanding the mechanisms of healing and adhesion formation in flexor tendon injuries?
  3. What areas are in need of further research for the treatment and prevention of flexor tendon adhesions?

Doctor’s Tip

One helpful tip a doctor might tell a patient about tendon repair is to follow a comprehensive rehabilitation program as prescribed by a physical therapist. This program typically includes specific exercises and stretches to help improve range of motion, strength, and flexibility in the affected tendon and surrounding muscles. Consistent and diligent adherence to the rehabilitation program can greatly improve the success of tendon repair and reduce the risk of complications such as adhesion formation.

Suitable For

Patients who may be recommended tendon repair include those with:

  1. Flexor tendon injuries of the hand, which can result from trauma, lacerations, or overuse injuries.
  2. Patients who have undergone surgical procedures to repair damaged tendons.
  3. Individuals with chronic conditions such as tendinopathy or tendonitis that require surgical intervention.
  4. Athletes who have suffered tendon injuries during sports activities.
  5. Individuals with congenital anomalies or deformities affecting the tendons.

Timeline

Before tendon repair:

  1. Injury: The patient experiences a hand injury that results in a flexor tendon injury.
  2. Diagnosis: The patient seeks medical attention and receives a diagnosis of a flexor tendon injury.
  3. Preoperative assessment: The patient undergoes preoperative assessment to determine the extent of the injury and the best course of treatment.
  4. Surgical consultation: The patient meets with a hand surgeon to discuss the surgical options for tendon repair.
  5. Surgery: The patient undergoes surgery to repair the damaged flexor tendon.

After tendon repair:

  1. Postoperative care: The patient receives postoperative care, which may include immobilization, physical therapy, and wound care.
  2. Rehabilitation: The patient undergoes a rehabilitation program to regain strength, range of motion, and function in the hand.
  3. Monitoring: The patient is monitored by healthcare providers to ensure proper healing and to address any complications.
  4. Follow-up appointments: The patient attends follow-up appointments with the surgeon to assess the progress of healing and to make any necessary adjustments to the treatment plan.
  5. Long-term management: The patient may need ongoing therapy and monitoring to prevent complications such as adhesion formation and to optimize the function of the repaired tendon.

What to Ask Your Doctor

  1. What is the success rate of tendon repair surgery for my specific injury?
  2. What can I expect during the recovery process after tendon repair surgery?
  3. What are the potential complications or risks associated with tendon repair surgery?
  4. How long will it take for me to regain full function and range of motion in my hand after tendon repair surgery?
  5. Are there any specific exercises or physical therapy techniques that can help improve my recovery after tendon repair surgery?
  6. How can I prevent adhesion formation after tendon repair surgery?
  7. Are there any lifestyle changes or modifications I should make to support the healing process after tendon repair surgery?
  8. What are the signs and symptoms of complications that I should watch out for after tendon repair surgery?
  9. Are there any alternative treatments or therapies that could complement my tendon repair surgery for optimal outcomes?
  10. How often should I follow up with you or a hand therapist after tendon repair surgery to monitor my progress and address any concerns?

Reference

Authors: Titan AL, Foster DS, Chang J, Longaker MT. Journal: Plast Reconstr Surg. 2019 Oct;144(4):639e-647e. doi: 10.1097/PRS.0000000000006048. PMID: 31568303