Injuries frequently seen in hand cuts that we encounter in hand surgery practice are tendon, nerve and vascular injuries. If there is damage to one of these structures, surgical treatment will probably be required. An examination by a relevant branch physician is necessary to determine whether there is an injury that requires surgery.
Tendons (beams) are the last parts of the muscles and are responsible for moving them by passing through the joints and adhering to the bones. The tendons that make the fingers bend and move are flexor tendons, and the ones that make the fingers open are extensor tendons. If there is difficulty in these bending or opening movements of the fingers, tendon damage has probably occurred. Almost all tendon injuries resulting from incision require surgical repair. Although the earlier the surgery is performed, the better, it is generally recommended to be performed within the first 7-10 days. Tendon cuts delayed for more than three weeks often cannot be repaired end to end, so additional procedures may be required. In addition, even if the surgery is performed on the first day, since the tendon is a mobile structure, the skin incisions are widened for the repair process due to retraction. In other words, after these surgeries, an incision larger than the current incision should be expected.
Nerves have two functions (sensory and motor nerves) to provide feeling and operate the muscles. The most typical finding is numbness and tingling-like numbness in the area of the cut nerve. Depending on the type of nerve cut, loss of function in some muscles may also occur. Nerve repairs are performed using microsurgical techniques. The recommended repair time is the first 3 days.
Vessels are the structures that bring blood to the limbs. If discontinued, active bleeding may occur. Generally, hand or finger nutrition is provided by more than one vein. Therefore, not every vascular incision may disrupt the nutrition of the limb, but it should be kept in mind that if there are color changes such as whitening or bruising on the skin, there may be a circulation problem. Vascular repairs are more urgent than tendon and nerve repairs. A hand or finger with a circulation problem should be treated as early as possible. Vessels, like nerves, are repaired with microsurgical technique.
Healing period:
The healing period after tendon, nerve and vascular incisions is important. Post-operative physical therapy and rehabilitation at least as much as the surgery itself The process also affects the functions. Postoperatively, a cast/splint is applied for varying periods of time depending on the type of injury. Unfortunately, it is not possible to return to work directly after surgery. Physiotherapy is applied during and after splinting. After nerve repair, nerve tissue is renewed starting from the repair line. Although this renewal rate varies from person to person, it is around one millimeter per day on average. Considering the level of the incision, recovery should not be expected in the early period. Unfortunately, if the level is high in nerve incisions, the recovery period is long.
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