• Reference Number: HEY-245-2021
• Departments: Physiotherapy
• Last Updated: 28 February 2019

Introduction

This leaflet has been produced to give you general information about your procedure.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is flexor tendon?

The flexor tendons originate from muscles in the forearm.  The tendons then pass across the wrist, through the palm and into the fingers and thumb.  As the muscles contract the tendons slide through the fingers, thumb and palm; bringing the finger tips into the palm and thumb across the palm, making a fist.  A damaged tendon needs to be repaired, in order for the hand to function properly.

Can there be any complications or risks?

Tendons are complex, intricate structures that are vulnerable following repair.  In order for them to function properly following your operation, it is important that you exercise your hand regularly and only as advised.  Too much, or incorrect exercise may cause the repaired tendon to snap.  Too little exercise may result in the tendons becoming stuck down with scar tissue, making them ineffective.

You should not

• Do any exercises that the physiotherapist has not shown you
• Force your fingers/thumb to straighten
• Use your injured hand at all. The tendons of all the fingers and thumb work together.  Using even uninjured fingers causes tension in the repaired tendon and will increase the chance of re-rupture

Splint and Elevation

A splint is made to protect your tendon whilst it heals.  It is vital that you DO NOT remove the splint until advised to do so by your doctor or physiotherapist.

Swelling is a normal reaction to surgery, however, it is important to limit this as much as possible:

• Wear your sling during the day for the first 3-5 days following surgery
• Keep your hand elevated when wearing your splint
• Elevate your hand on pillows at night
• If your hand remains swollen continue the elevation until it settles

Exercise

The physiotherapist will demonstrate the exercises which you should continue to do regularly at home.  The strap should be removed from your fingers or thumb before exercising.

Full Passive Flexion

Use your unaffected hand to bend, individually, the fingers or thumb of your affected hand.  Try to make the finger tips touch the palm of the hand.  Make sure all three joints are bent on each finger. The thumb should be bent at the end joint

Active Extension

Using only your injured hand, open out your fingers/thumb until your nails touch the splint.

Active Flexion

Using only your injured hand, curl your fingers into a fist.  Do not clench your fist tightly.  Bend the tip of your thumb.  DO NOT pull into pain, or against any resistance.

Do each exercise ________ times every ______ hours

Recovery period

A tendon will repair by forming a scar, rather like a cut on the skin.  However, a tendon takes much longer to heal, and remains vulnerable for several weeks after the skin wounds have healed.

This is only a guide and may vary according to individual injuries.

0 – 4 weeks    Wear the splint at all times. Do exercises in the splint

4 – 6 weeks    Splint may be removed for gentle exercise only and then reapplied

6 weeks         Splint may be discarded. Commence light functional activities, for example washing and dressing

7 weeks         Return to driving if safe to do so.

8 weeks         Return to normal use, but avoid heavy lifting

12 weeks       Return to heavy or manual work, contact sports etc.

Contact details

 If you have any problems or questions call the Physiotherapy Department on the following telephone numbers:

Castle Hill Hospital (01482) 622296 (Monday to Friday)

Hull Royal Infirmary (01482) 608764 (Monday to Friday)

Plastic Surgery Trauma Clinic HRI (01482 674509) (daily including weekends and bank holidays)

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.