Tendon repair in the hand is an operation to rejoin a cut or ruptured tendon, restoring the ability to bend or straighten the finger. Tendons do not heal reliably on their own and surgical repair is usually required.
An incision is made over the injured area (or the existing wound is extended). The cut tendon ends are identified and stitched together using strong sutures. The wound is closed and the hand is placed in a protective splint. Flexor tendon repairs are technically demanding procedures. The operation takes 45–90 minutes depending on the number and location of tendons injured.
Surgery is recommended for all significant tendon injuries in the hand, as tendons cannot heal without surgical repair. Delay in treatment may make repair more difficult.
Partial tendon injuries (less than 60% of the tendon width) may sometimes be managed with splinting alone. Complete tendon divisions always require surgical repair. In some cases where repair is not possible, tendon grafting or transfer may be considered.
Tendon repair is usually performed as an urgent or semi-urgent procedure, ideally within days of the injury. Standard pre-operative assessment and fasting are required.
The aim is to restore tendon function and allow the finger to move normally. With careful surgery and dedicated hand therapy, most patients achieve a good functional result. However, some stiffness and loss of range compared to normal is common, particularly with flexor tendon injuries in the finger.
Scar tissue around the repair can restrict tendon gliding. This is the most common challenge. Hand therapy is essential.
Some limitation compared to the uninjured finger is common.
Hand swelling is expected and improves over weeks.
The repaired tendon may re-rupture, especially if loaded too early or too aggressively. This may require further surgery.
Scar tissue binding the tendon to surrounding structures, limiting movement. May require further surgery (tenolysis).
Wound infection, which may compromise the repair.
Associated nerve injuries may be present with the original injury.
Usually performed under general anaesthesia or regional arm block. Occasionally under local anaesthesia.
A protective splint is worn for four to six weeks. Hand therapy begins within the first few days — a carefully controlled exercise programme protects the repair while maintaining tendon glide. The therapy regime is critical to the outcome. Full recovery takes three to six months. Return to heavy manual work may take longer.
Hand therapy begins within the first week. Wound review and suture removal at 10–14 days. Surgeon review at six weeks. Ongoing hand therapy for several months.
The repaired tendon needs to be moved carefully to prevent it from sticking to surrounding tissues, while also protecting the repair from rupture. This requires a carefully balanced exercise programme supervised by a specialist hand therapist.
If the repair ruptures, further surgery is usually needed. This may involve a new repair, a tendon graft, or a staged reconstruction depending on the timing and circumstances.
Most patients achieve good functional recovery, particularly with dedicated hand therapy. Some degree of stiffness compared to the uninjured finger is common.