What it is
Tendon repair surgery restores the continuity of a torn flexor or extensor tendon, allowing for the return of finger motion and strength. Flexor repairs often use a dorsal blocking splint and early protected motion. Extensor repairs may use relative motion splinting. The plan is precise and requires adherence to range and load limits.
Rehabilitation protects the repair, restores glide, and then builds strength and dexterity. Early protected motion prevents adhesions while guarding against rupture.
What happens when it occurs
Sutures reconnect the tendon ends. A custom splint positions the wrist and fingers to reduce tension on the repair. Guided exercises restore glide without overload. Progression depends on the tendon, zone, and the strength of fixation.
Common causes and risk factors before surgery
- Lacerations from tools or glass
- Avulsion injuries during sport or falls
- Degenerative tendon change in older adults
Who is most affected
Trades, DIY injuries, sports incidents, and older adults with degenerative tears.
Typical symptoms before surgery
- Loss of active finger motion
- Pain and swelling over the tendon path
- Functional limits in grip and dexterity
When to seek care
Immediately after suspected tendon laceration or when active motion is lost.
How we diagnose
History, functional testing of each tendon, and ultrasound in selected cases. Wound assessment guides timing and planning.
Management
- Custom splinting (dorsal blocking for flexors; relative motion for extensors)
- Early protected motion under therapist supervision
- Scar care and oedema management
- Progressive strength and dexterity when healing allows
- Explicit criteria for return to work and sport
Rehabilitation milestones
Phase 1 weeks 0–3: protection, passive and place-and-hold motion by protocol.
Phase 2 weeks 3–6: increase excursion, begin light activation in the splint.
Phase 3 weeks 6–12: wean splint, progressive resistance and dexterity drills.
Phase 4 months 3–6: power, endurance, and task-specific return.
Readiness to progress
- Wound and tendon healing confirmed
- Glide restored without triggering or lag
- Strength and dexterity trending toward targets
Long-term care
- Maintain glide with periodic tendon exercises
- Protect from sudden heavy loads early in return
- Keep forearm and intrinsic strength
Australia snapshot
- Common after DIY and workplace incidents
- Hand therapy and custom splinting are accessible in most regions
- Adherence to protocol strongly predicts outcome
Latest insights
Protected motion prevents adhesions without risking the repair.
Clear rules for range and load make recovery predictable.
