Flexor Tendon Injuries

The flexor tendons are tendons that start in the forearm, extend down to the fingers, and are responsible for flexion of the fingers, of bending them into the palm. Each finger has two flexor tendons; the thumb has one.

The flexor tendons are part of a very complex anatomic arrangement in the palm and fingers. Their beautiful and graceful anatomy give us the fine dexterity as well as power that we always depend on in the use of our fingers and hand.

Yet, the flexor tendons can be subject to major malfunction, especially in trauma. Cuts and lacerations to the hand, as well as crush injuries, can cause major damage to the flexor tendon system. Without expert repair and expert hand therapy, hand function can be impaired in a major fashion.

The big challenge in flexor tendon surgery is to repair the tendons and get them moving quickly to avoid excessive scar formation between the tendons and the surrounding tissues. If a great deal of thick scar forms, the tendons will become stuck in the scar and be totally incapable of moving the fingers. Therefore, minimizing and modulating this scar tissue is absolutely critical to ensure the best result after flexor tendon injury.

Minimizing the scar is generally done by using meticulous delicate surgical technique. The tolerances for error in the hand, especially the flexor tendon system, are very small. While it is not so difficult to get the tendons connected, it can be very difficult to get them moving and functional after injury.

Flexor tendon surgery is usually done in a surgery center. It can be done as an outpatient. Therapy should commence no later than 3 to 5 days after the surgery, and is crucial to success.