Tendon Laceration: Causes, Symptoms, Treatment, Recovery Period

A tendon is a thread like structure which attaches a muscle to a bone.¹ It is a strong fibrous tissue whose function is to transfer the force generated by the muscle to the bone resulting in movement of the joint. Since tendons are thin tissue like structures they can be cut on occasions. When this happens it is termed as a Tendon Laceration. Tendon Laceration usually occurs after a deep cut to the skin. Tendon Laceration sometimes can also cause damage to the nerves and other surrounding structures as well. As stated, the most common cause of a Tendon Laceration is a cut to the skin. This cut can be due to a kitchen knife, an assault by a sharp object, and even a gunshot wounds where the bullet may cause a Tendon Laceration.

Tendon Lacerations are mostly seen in the palms of the hands and the tendons most vulnerable to lacerations are the flexor and extensor tendons of the hands. A Tendon Laceration may result in loss of mobility apart from acute pain. Tendon Laceration requires immediate attention so that further damage to the tendon can be prevented.

As stated, deep cuts to the skin is the root cause of a Tendon Laceration. A simple cut to the skin by a knife or a broken glass can cause a Tendon Laceration. Apart from this, an assault with a sharp edge object like an axe or a gunshot wound can also cause Tendon Laceration. Certain sporting activities like football and wrestling can also result in Tendon Laceration. There are also certain medical conditions which make the tendon weak and prone to Tendon Laceration of which the most common is rheumatoid arthritis.

Anyone can have a Tendon Laceration but it is seen more commonly in people who work in the kitchen for long periods of time using the knife. Meat cutters are also at risk for Tendon Lacerations. Athletes involved in wrestling and football are also at an increased risk for Tendon Laceration. People suffering from conditions like rheumatoid arthritis are also at an increased risk for sustaining a Tendon Laceration.

Some of the symptoms of Tendon Laceration are:

• Open injury at the affected region with bleeding
• Inability to move the affected area ²
• Pain with motion of the affected area
• Loss of sensation with numbness around the injury site.

To diagnose Tendon Laceration, the physician will first carefully inspect the wound and the surrounding areas looking for any deformity or deep cuts, swelling and signs of bruising. The physician will then order radiological studies in the form of x-rays, MRI or CT scans which will confirmatively diagnose Tendon Laceration.

Tendon Laceration is mostly treated surgically but first certain nonsurgical methods are adopted. Some of the treatment methods adopted for treatment of Tendon Laceration are:

Conservative Treatment for Tendon Laceration: This is done in the form of using splint to immobilize the area, icing the affected area, and use of NSAIDs to reduce pain and inflammation, although this treatment is not definitive.

Surgical Treatment for Tendon Laceration: Majority of Tendon Lacerations are treated by way of surgery. During the surgical procedure, the affected tendon is identified and repaired. Ice and antiinflammatories are given preoperatively for comfort and soft tissue healing. The surgery done to treat Tendon Laceration is a minimally invasive surgery which sutures the cut tendon back together. It should be noted here that the Tendon Laceration may either be a straight cut or the cut may be at an angle and hence suturing depends on the type of the cut. In some cases, the ends of the tendon can be sutured together or a suture is made directly to the bone. After surgery, a cast or splint is required for immobilization allowing the tendon to heal for a period of about six weeks.

Following the surgical repair of tendon laceration; hand therapy would be in the process of treatment.

• Hand therapy will focus on gradual weaning off the immobilizing device and restoration of the normal range of joint movement and strengthening of the muscles where tendon laceration has been surgically treated.
• You must have a proper idea about the hand therapy from your physician or hand therapist before beginning of the therapy.
• It must be informed that emphasis will be more on rest, tendon protection, reducing the inflammation and improving the circulation of blood to the treated tendon for quick and effective healing. So, hand therapy for a tendon laceration must remain conservation at the beginning so as to protect the surgical repair of the tendon. Slowly and gradually following the timeline and protocol of the surgeon; hand therapy must be initiated which may include a progressive range of motion, stretching and strengthening.

Individuals with tendon laceration generally do well, in case repair and treatments are done immediately without delay. Delaying can result in scar tissue formation and retraction of the tendons. Apart from this delayed treatment; there may be other factors which may affect the functional outcome of treatment for tendon laceration.

These factors may include the following.

• Age of the patient. Older patients are usually weaker and may take long time to heal
• Health of the individual and their strength. Good Health and strength of the patient is considered to be a positive point in quick and effective recovery from tendon laceration after the treatments.
• Tissue quality. Tissue quality before the surgical treatment will affect the recovery or healing following the surgical treatment. Poor blood circulation and presence of scar tissue will interfere with the process of healing.

If treatment is initiated immediately after surgery, then it may take up to a month for the tendon laceration to completely heal and for the individual to get back to normal activity. Some of the other factors that may delay the recovery time of tendon laceration are:

Age: Elderly people with tendon laceration take a longer time to heal as their tendons are weak and their overall immune state is compromised

Overall Health: The overall health of the patient also defines the time it will take for them to completely recover from tendon laceration. Healthy individuals heal faster than people with other underlying medical conditions.

It normally takes about a month for an individual to recover from Tendon Laceration but in some cases it may take about to three months before an individual can return to normal activities after sustaining a Tendon Laceration.

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