The majority of injuries in the hand area are caused by tendon cuts. While the flexor tendons of the fingers are affected in incisions on the palmar side of the hand and wrist (palm), the extensor tendons are affected in incisions on the dorsal side (top of the hand).
Flexor Tendons
Flexor tendons of the hand are affected. These are structures located in the palm of the hand, starting from the forearm and extending to the finger bones, and allowing the fingers to bend. Flexor tendons can be damaged as a result of situations such as cutting the palm, crushing the hand, or receiving a penetrating blow. This type of injury, which does not appear to be a significant wound when viewed from the outside, is very important for the function of the hand. While the flexor tendon is only injured in some cases, in other cases it may rupture directly. If the flexor tendon is injured, the patient cannot bend the fingers, and in case of rupture of the tendons, the fingers may move backwards like rubber, since the structure holding the fingers is destroyed.
In case of flexor tendon injuries, in case of tendon rupture, no treatment method other than surgery can be applied. During surgical intervention, the ruptured flexor tendon and vascular and nerve cuts, if any, are repaired.
The treatment process to be continued after the surgery; It may vary depending on the degree, shape and injured area of the injury. In all cases, a rehabilitation process is required to regain the lost function of the hand. In addition to this rehabilitation process, medical devices such as splints can also be used to fix the tendon.
Extensor Tendons
As a result of injury to the extensor tendons, lifting the fingers and wrist upwards becomes very painful and even impossible. may come. Anesthesia may be used during examination of an extensor tendon injury. In this way, fingers that cannot normally be moved can be moved and the seriousness of the situation is understood. In addition, the patient's wrist movements are examined while the patient is awake and the patient is asked to place his hand on the table and lift his fingers one by one. It is possible to restore the extensor tendon to its former state with surgical intervention. This surgical intervention method usually restores the torn or dislocated tendon. It is realized by duplication. In some injuries, areas close to the finger joints are damaged. The tendon structure is quite thin in these regions. Therefore, while the torn or dislocated tendon is being stitched, the finger joints may need to be fixed with wire to prevent these stitches from falling out and the problem from reoccurring. Methods such as splinting and finger ring application can be used as treatment methods for injuries that occur as a result of separation of the extensor tendon from its attachment point to the joint. In this treatment, it is applied to bring the tendon closer to the place where it was separated and reattach it.
Due to the structural features of the extensor tendon, loosening of the sutured tendon may be observed after the surgery. To prevent this situation and ensure a full recovery, splint treatment is applied for 5 weeks after the surgery. In addition to splint treatment, rehabilitation is also important in the treatment process. Other factors affecting the extensor treatment process are the level of injury, the type of injury, the surgical method applied, the patient's constitution and motivation, and early initiation of rehabilitation.
The Importance of Early Intervention in Tendon Incisions
Paying attention to tendon incisions. Another important point is that intervention against injuries should be carried out in a very short time. As a result of delayed intervention, the function of the hand cannot be fully regained, and situations may occur that may cause difficulties in the surgical intervention. For example, if the treatment of a tendon that is damaged but not ruptured is delayed, the tendon may rupture completely during this process. In this case, the patient suffers much more pain and the treatment method to be applied becomes more complicated. Another example is that as a result of delaying the surgical procedure for the ruptured tendon, the length of the tendon shortens due to the pulling of the muscle to which the tendon is attached, and it becomes impossible to connect the two ends of the ruptured tendon.
The Importance of Rehabilitation in Tendon Injuries
Obtained The aim of the rehabilitation phase, which is carried out during the treatment of tendon injuries, is to ensure the use of the recovered and corrected tissues of the damaged hand to the highest possible degree and to return the hand as close as possible to its functional and aesthetic state before the damage. is his wife. In addition, rehabilitation helps eliminate complications that may occur after surgery.
Tindon injuries in the hand are very important cases that may result in complete loss of hand function. Treatment of hand tendon injuries is possible, but treatment should not be delayed.
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