Hand and upper extremity surgery is a specialized field focused on repairing and reconstructing tendons, which are vital for restoring mobility and function to the upper limbs. Tendon injuries can result from traumatic incidents, repetitive strain, or degenerative conditions, causing pain and limiting the ability to perform daily activities. This article delves into the types of tendon injuries, the surgical techniques used for reconstruction, and the recovery process.

Understanding Tendon Injuries

Tendons connect muscles to bones and play a crucial role in hand and arm movements. Common tendon injuries include:

• Flexor tendon injuries: Affecting the tendons that bend the fingers.
• Extensor tendon injuries: Impacting the tendons responsible for extending the fingers.
• Rotator cuff tears: Affecting the shoulder tendons that assist in arm movements.
• De Quervain's tenosynovitis: Involving inflammation of the tendons on the thumb side of the wrist.

Surgical Techniques for Tendon Reconstruction

When conservative treatments such as physical therapy or splinting fail, surgical intervention may be necessary. Common techniques include:

• Tendon Repair: This technique involves suturing the torn ends of a tendon together to promote healing and restore function. Surgeons may use specialized stitching techniques to enhance strength and repair quality.
• Tendon Grafting: For severely damaged or ruptured tendons, grafts from other tendons may be used to replace the damaged sections, thus restoring functionality.
• Tendon Transfer: In cases where a tendon cannot be repaired, a surgeon may reposition a healthy tendon to compensate for the lost function, effectively allowing movement through alternative pathways.
• Tenolysis: This procedure is performed to release scar tissue around a tendon, promoting improved movement and function in the affected area.

Post-Surgery Recovery and Rehabilitation

Recovery from tendon reconstruction surgery typically involves several stages:

• Immobilization: Following surgery, the hand or arm is usually immobilized in a splint or cast to provide stability during the initial healing phase.
• Physical Therapy: Once healing begins, a physical therapist will guide patients through a rehabilitation program aimed at restoring flexibility and strength. This can include gentle exercises and stretches.
• Gradual Resumption of Activities: As strength and range of motion improve, patients can gradually return to daily activities, though some may need to avoid high-impact activities for several months.

Conclusion

Hand and upper extremity surgery for tendon reconstruction offers patients a pathway to regain mobility and functionality after tendon injuries. By utilizing a range of surgical techniques and a thorough rehabilitation process, patients can look forward to returning to their everyday activities with improved strength and reduced pain. If you or someone you know is struggling with a tendon injury, it’s essential to consult with a hand specialist to explore the best treatment options available.