Repair of Tendons in the Hand

How Tendons in the Hand Are Surgically Repaired in Houston, Texas

If you are experiencing strained muscle movement, you may need surgical repair of the flexor tendons, EPL tendon or extensor tendons in your hand or fingers. Houston-based board certified hand specialist, Dr. Jason Ashford, can discuss your symptoms, test to better understand the type of  tendon injury, and if you may need tendon transfer surgery. 

How does a tendon work?

The tendon is the strong cord at either end of a muscle that is attached to the bone. Tendons, combined with muscles, allow you to move your joints. If damaged, tendons may be pulled off the bone and your movement will be hindered. If this happens you may not be able to bend your fingers and the range of movement would be limited.

In the forearm and hand there are over 40 different muscles. Many of these muscles perform overlapping functions, so after a tendon injury, some of your muscles may not move correctly.  

If you are suffering from an injury that prohibits movement, you may need a repair of tendons in your hands to help the muscles move properly. If you are in the Houston, Texas area and are experiencing such an issue, board certified hand specialist, Dr. Jason Ashford is here to help.

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How do you treat an injury to the tendon in my hands?

Oftentimes when there is an injury to the tendon in the hand we will suggest a tendon transfer surgery. A tendon transfer is a surgery that replaces a non-working muscle and tendon with a working muscle and tendon.

For example, after you break a wrist, the tendon to the thumb (EPL tendon) that allows you to make a “thumbs-up” can break. Often, the two ends of the tendon are too damaged to be sewn back together. There are two tendons that extend the index finger, and this finger can function adequately with just one. A hand surgeon can transfer one of the index finger tendons to the thumb to allow you to give a “thumbs-up” again.

What can cause the need for surgery on a tendon in the hand?

You may need tendon transfer surgery to restore function to a muscle or tendon because of a:

  • Nerve injury
  • Carpal tunnel (compression of the median nerve)
  • Muscle injury (trauma, rheumatoid arthritis) 
  • Neuromuscular disorder (cerebral palsy, stroke, traumatic brain injuries and spinal muscle atrophy) 
  • Birth defect (infants born without certain muscle functions) 

What does tendon transfer surgery entail?

The surgeon may perform the surgery with you awake, they may administer mild sedation, or they may have you completely asleep. The type of anesthesia they use depends on your injury, and it is a decision you and your surgeon will make together.

The surgeon will make one or more incisions in the skin. After finding the tendon of the extra muscle, the surgeon will move it and sew it on to the tendon of the muscle that is not working. Sometimes, the surgeon will need to do more than one tendon transfer at a time. The surgeon finishes the procedure by closing the skin with stitches.

What will my recovery look like?

After surgery you may need a cast or splint to protect the new tendon transfer until the tendon heals to its new position. This usually takes one to two months. The need for post-surgery hand physical therapy and the timing of therapy varies, and you can discuss that with your surgeon. It is important to attend hand therapy if your surgeon suggests it and to follow your therapist’s instructions closely.  

Are there risks if I choose a surgery to repair the tendons in my hand?

The early risks are rare, but can include bleeding, infection or injury to nearby nerves, tendons or blood vessels. Later risks include hand stiffness, weakness of the transferred muscle or rupture of the transfer and need for another surgery.

Are there other treatment options?

Your hand surgeon will discuss with you if there are any alternative treatment options to tendon transfer surgery for your particular injury to your tendons in your hand. 

Some alternatives include:

  • Repair or transfer of nerves 
  • Repair of muscle or tendon 
  • Splinting or fusion of joints

If you have more questions about an injury to the tendons in your hand or want a surgeon recommendation, please make an appointment with Dr. Jason Ashford at the hand center in Houston and Conroe, Texas.

Schedule My Appointment With Dr. Ashford