A common cause of flexor tendon ruptures is usually sports related injuries. This can happen through innocuous incidents such as when a footy player’s finger gets caught in a jumper while trying to tackle an opponent (commonly referred to as a Jersey Injury).
Open lacerations can make the tendon incision a little more obvious however, closed ruptures are more difficult to work out clinically (for example, if the tendon is partially torn or completely ruptured).
When we are looking at a patient’s hand with suspected flexor tendon injuries, we look for the following:
- Loss of normal tension with the affected finger (lose the natural curved position of the fingers)
- Tenodesis (extension of the wrist does not produce finger flexion)
- No tendon pull through (on testing – next slide)
Simple Clinical Tests To See If The FDP And FDS Are Working
It’s really important when doing an ultrasound on the affected finger, to not just scan the distal aspect of the finger, as the distal portion may be intact, but to also check the tendon as it may be ruptured more proximally.
When it comes to flexor tendon injuries, it is not appropriate to treat these conservatively. In fact, the earlier patients are operated on the better. If it is delayed, even by one week, the patient may require a two-stage repair as the tendon contracts and cannot be repaired end to end.
Treatment following surgery is quite an involved process. It is a balance between protecting the newly repaired tendon whilst also moving and gliding the tendon to reduce the chance of adhesions forming.
Article Reference: Melbourne Hand Therapy