Houston Methodist. Leading Medicine

Hand FAQ

Question:

My husband cut his hand when doing a roofing project at home. He lacerated the flexor tendon of both the ring and baby fingers of his left hand. He's in surgery and I'm searching the internet for any information I can find to help during recovery. What advice can you offer us?

Answer:

The best advice we can offer is to follow the instructions your surgeon gives you as closely as possible. He or she knows what exactly was done and how much load, stress, and pressure the healing tissue can handle. At the same time, it might be helpful if you had a little background information about flexor tendon injuries. For example, back in the 1970s, hand surgeons discovered that early motion after flexor tendon repairs yielded better results. Putting the hand in a splint that blocked some motions but allowed others was better than no motion at all. Those early studies supported the idea that motion is lotion. Since that time, research has continued in the area of hand therapy. Hand rehab programs have expanded to include all kinds of different ideas for post-op positioning, motion, and exercise. So you can expect your husband to be treated by a hand therapist early on after surgery. Some interesting findings from a recent study might be helpful, too. In the study, the use of a passive motion program was compared with early active motion therapy. The authors believe this is the first study published comparing these two hand therapy techniques. Passive motion refers to the fact that someone else other than the patient (in this case, a hand therapist) is moving the affected fingers. Active motion means the patient is moving the finger by himself. The results were striking. Patients in the early motion group had significantly better outcomes. They had much more motion, fewer (and less severe) joint contractures, and better dexterity (e.g., picking up small objects, using fingers to manipulate objects). Not surprising, the early motion group with the better results were also much happier with the progress they made after surgery. Patients treated by a certified (specially trained) hand therapist also had better outcomes. There were some negative predictive factors to take note of. A negative risk factor means that when either of these factors were present, the patients were more likely to have worse results. In this study, cigarette smokers, patients with more than one finger laceration, and those with nerve injuries seemed to have the worst results. There's not much someone can do to change the injury once it has happened. So your husband's two finger involvement increase his risk of complications. But if he smokes or uses tobacco, he would do well to reduce his tobacco use (eliminate it if possible during the healing and recovery phase). Good nutrition is also essential. And, of course, as mentioned -- follow the surgeon and the therapist's directions carefully. Thomas E. Trumble, MD, et al. Zone-II Flexor Tendon Repair: A Randomized Prospective Trial of Active Place-and-Hold Therapy Compared with Passive Motion Therapy. In The Journal of Bone and Joint Surgery. June 2010. Vol. 92-A. No. 6. Pp. 1381-1389.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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