Flexor tendons curl the fingers toward the palm; extensor tendons straighten them. Either can be injured through lacerations to the wrist, forearm, palm or fingers, through forceful trauma in sport or accidents, or through spontaneous rupture in patients with rheumatoid arthritis where weakened tissue is more prone to tearing.
The most common presentation is a cut to the hand, often one that looks minor, that severs one or more tendons. The result is a finger that will not bend or straighten. Surgery needs to be performed as soon as possible: delayed presentation significantly complicates repair and may require a more involved two-stage reconstruction.
The procedure involves exploring the wound, locating the cut ends of the tendon and repairing them with specialised stitching techniques. When the injury is presented late and direct repair is no longer possible, a two-stage repair using silicone rods may be required. Post-operative splinting and a strict physiotherapy protocol are just as important. Without them, even well-performed surgery will not give a good functional result.