Wrist and hand tendon injuries involve damage to the tough cords of tissue that connect muscles to bones in the wrist and hand area. These injuries can affect the ability to bend or straighten the fingers and thumb.

Flexor tendon injuries:

• Flexor tendon lacerations or cuts from sharp objects like knives or glass
• Jersey finger – a flexor tendon avulsion injury where the tendon is pulled off the bone, common in sports like football
• Flexor tendinitis from overuse or repetitive activities

Extensor tendon injuries:

• Mallet finger – the tip of the finger droops due to a torn extensor tendon
• Boutonniere deformity – inability to straighten the middle joint of the finger due to an extensor tendon injury
• Extensor tendon lacerations from cuts on the back of the hand

Other tendon injuries:

• Tendon tears or ruptures from trauma or overuse
• Trigger finger/thumb – a tendon gets caught in a sheath when bending
• Intersection syndrome – pain from inflamed tendons crossing over each other in the wrist
• De Quervain’s tenosynovitis – inflammation of the tendon sheath in the wrist and thumb area

The most common causes are cuts/lacerations from sharp objects, repetitive strain from overuse, and sudden trauma like jamming a finger or getting it caught. Proper precautions like wearing protective gear and avoiding unsafe practices can help prevent many of these injuries.

Common Symptoms

• Inability to fully bend or straighten fingers/thumb
• Pain with movement
• Swelling
• Bruising
• Weakness in the affected area
• Snapping or popping noise at time of injury

Cause & Anatomy

Common causes of Tendon Injuries:

• Overuse and repetitive motions (e.g. tennis, typing)
• Sudden trauma (falls, cuts, jamming finger)
• Direct trauma (punches, door slams)
• Handling sharp objects

There are two main groups of tendons involved:

• Flexor tendons on the palm side that bend the fingers/thumb
• Extensor tendons on the back of the hand that straighten the fingers/thumb

Diagnosis

Physical examination by a hand specialist to assess range of motion, pain, and tendon function. Imaging tests like X-rays or MRI may be ordered.

Prevention

• Stretching and warming up before activities
• Using proper technique when exercising/lifting
• Taking precautions when handling sharp objects/machinery

Treatment

• Immobilization with a splint or cast for partial tears
• Surgery to reattach completely torn tendons

Surgery

Torn tendons are surgically repaired by stitching the severed ends back together. Nerve damage may also be repaired.

Rehabilitation

After surgery, rehabilitation with a hand therapist is crucial, involving:

• Splinting to protect the repair for 6 weeks but some injuries need early motion
• Controlled range of motion exercises
• Gradual progression based on the injury or surgery type

FAQ’s

What if I suspect a tendon injury?
Seek an evaluation from a hand surgeon as soon as possible.

Is this a jammed finger?
Some jammed fingers get better but many are more severe injuries with long term consequences. They can be similar in how they appear. A correct diagnosis, the right splint, and the right timing for mobility are crucial for success. See your orthopedic surgeon to make certain it does well.

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