Plastic Surgery · Jaipur Hospital
Hand Tendon Repair in Jaipur
You cannot move your finger after a cut or injury. We assess, explain options and plan your repair.
- Serving Jaipur since 1991 (35 years)
- NABH accredited
- 24×7 emergency & ICU
- Cashless: RGHS, MAA Yojana, CGHS + 32 insurers
- Operation time
- 1 to 2 hours
- Anaesthesia
- Regional or General anaesthesia
- Recovery
- Protected motion 6 weeks, full strength 3 months
- Price
- ₹35,000 to ₹90,000typical range in India; ask us for an estimate
Finger will not bend or straighten
Your finger stays straight or bent after an injury
A deep cut on the palm side of your wrist or finger can sever the tendon that pulls the finger. You may see an open wound, but sometimes the skin closes while the tendon remains torn. You cannot bend the finger tip, or it hangs loose. Without repair, the finger will not work.
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Cannot bend finger tip
The tendon that pulls the finger is cut or torn away from the bone.
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Finger hangs loose
An extensor tendon injury leaves the finger drooping at the last joint.
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Cut on palm or wrist
A deep laceration may have divided the tendon even if the skin looks closed.
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Rubbing sensation with movement
You feel a grating or catching when you try to move the injured finger.
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Loss of grip strength
The hand feels weak and you cannot hold objects as before.
Patients present with an inability to flex the interphalangeal joint associated with pain and a rubbing sensation.
Why Jaipur Hospital
You worry that your hand will never work the same, that you will lose income, and that the surgery and therapy will take months.
Your care plan
Your first steps with us
- 1 Call or visit OPD for surgeon consultation
- 2 Get scans and tests done in-house
- 3 Have microsurgical repair under regional or general anaesthesia
- 4 Follow protected motion rehab for six weeks
How the operation is done
The surgeon finds the cut ends of the tendon under magnification and stitches them together with strong core sutures and a fine outer suture. The wound is closed and the hand is placed in a protective splint.
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Primary Repair
Direct suture of the tendon usually within 24 hours of a clean cut.
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Delayed Primary Repair
Repair performed within two weeks once swelling has settled and tissue is healthy.
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Tendon Graft
Two-stage reconstruction using a tendon graft when the gap is too large for direct repair.
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Tenolysis
Release of scar tissue sticking the tendon down after the initial repair has healed.
Why patients trust us
- 1991 Serving Jaipur for 35 years
- NABH Accredited hospital
- 1 Plastic Surgery consultants
- 24×7 Emergency, ICU and ambulance
- 35 Cashless schemes and insurers
What research shows about tendon repair
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About 4 in 100 repairs rupture
The incidence of rupture after flexor tendon repair was 4% in published series.
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About 6 in 100 need re-operation
The incidence of re-operation after flexor tendon repair was 6% across studies.
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Over 80% good or excellent outcomes
Over 80% good or excellent outcomes achieved rather consistently after Zone 2 repair.
If it is left untreated
If a cut tendon is not repaired, the finger will not bend or straighten on its own. The tendon ends pull apart and scar tissue fills the gap. Later reconstruction becomes harder and results are less predictable.
Life after treatment
Most people regain useful finger movement after surgery and months of hand therapy. The tendon heals while you follow a strict splint and exercise plan.
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Finger bends again
Most people regain active flexion of the finger tip within three months.
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Grip returns
Grip strength was good in 63.8% of patients at six months in one study.
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Daily tasks improve
You can usually hold a pen, use a phone and button a shirt again.
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Scar softens over time
The surgical scar on the palm or finger fades and becomes less sensitive.
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Frequently asked questions
Questions patients ask about hand tendon repair
What does hand tendon repair involve?
In short
Hand tendon repair at Jaipur Hospital involves microsurgical stitching of a cut or ruptured tendon in the hand. The operation usually takes one to two hours under regional or general anaesthesia. You may go home the same day or stay one night. Protected motion begins after surgery and continues for about six weeks, with full strength returning around three months.
In detail
The surgeon makes a small incision to find the divided tendon ends and sutures them together using strong core stitches and a finer outer suture.
Techniques include primary repair within 24 hours, delayed primary repair up to two weeks, or a two-stage tendon graft for chronic loss. Evidence shows that adding an epitendinous suture reduces re-operation rates and modified Kessler technique lowers adhesion formation.
Early controlled motion protocols such as Duran passive mobilisation are started soon after surgery to glide the tendon and limit stiffness.
A common belief
Many people think the tendon heals on its own or that you can move the hand freely right after surgery.
What actually happens
In reality, the repair is delicate and needs a strict splint and passive exercise programme for six weeks to prevent the stitches from pulling apart or the tendon sticking down.
Your next step at Jaipur Hospital
After the operation your hand will be placed in a dorsal splint with the wrist and fingers positioned to protect the repair. A hand therapist will teach you passive exercises every two hours for the first four weeks. Splint wear is gradually reduced over eight weeks. Strengthening begins after week eight. Full recovery takes about three months.
Which tests and scans do I need before hand tendon repair?
In short
Before hand tendon repair at Jaipur Hospital most patients need only a clinical examination. Routine blood tests such as haemoglobin, blood sugar, and infection markers are done for anaesthesia safety. An X-ray may be ordered if a fracture is suspected. Ultrasound is sometimes used to confirm a tendon gap or partial tear when the examination is unclear.
In detail
The surgeon's primary tool is the bedside test of active finger motion. Evidence shows that in clean lacerations the clinical diagnosis is reliable. Blood work ensures you are fit for regional or general anaesthesia.
If the injury involved crushing, glass, or a fall, an X-ray checks for bone fragments or a foreign body. Ultrasound can visualise the tendon ends and measure the gap, which helps plan a primary repair versus a graft. MRI is rarely needed and only for complex cases with suspected deep infection or nerve involvement.
A common belief
People often expect an MRI or CT scan for every hand injury.
What actually happens
In reality, those are rarely needed. The surgeon's hands-on test of finger movement is the most accurate way to decide if the tendon is cut and whether it can be repaired directly.
Your next step at Jaipur Hospital
On the day of your pre-operative visit the nurse will draw blood and the radiology department will perform any X-ray or ultrasound the surgeon has requested. Results are usually available the same day. If all tests are normal, surgery can be scheduled within a few days.
What are the common side effects and the less common serious complications of hand tendon repair?
In short
After hand tendon repair at Jaipur Hospital, common side effects include swelling, stiffness, and discomfort around the wound and fingers. You will wear a splint that limits movement for several weeks. These effects are expected and usually improve with guided therapy.
In detail
Evidence shows that adhesion formation, where the repaired tendon sticks to surrounding tissue, remains a common complication even with careful repair. In studies, the incidence of adhesions after flexor tendon repair was about 4%, and the rupture rate was also around 4%.
Re-operation occurred in roughly 6% of cases. Using an epitendinous suture lowers re-operation risk by 84%, and the modified Kessler technique reduces adhesion development by 57%. Early passive motion protocols carry a lower rupture risk than early active motion but may lead to more stiffness. Infection and nerve injury are less common but possible serious complications.
- Re-operation occurred in roughly 6% of cases.
A common belief
Many people think the repair itself is the main risk, but adhesions and stiffness are more frequent.
What actually happens
Studies show adhesion rates around 4% and rupture rates around 4%. Re-operation happens in about 6% of cases. Good surgical technique and the right motion protocol lower these risks.
Your next step at Jaipur Hospital
Your surgical team will explain the specific signs to watch for, such as sudden loss of finger movement, increasing pain, redness spreading from the wound, or fever. Attend all follow-up appointments so healing can be checked. Hand therapy usually starts within days and continues for months.
How long does recovery usually take after hand tendon repair?
In short
Recovery after hand tendon repair at Jaipur Hospital is a staged process. Protected motion in a splint typically lasts six weeks. Regaining full strength and function usually takes about three months, though some stiffness may persist longer. The exact timeline depends on the tendon injured, the repair technique, and how closely you follow the therapy programme.
In detail
Evidence from structured rehabilitation programmes shows therapy starts the first day after surgery and continues for twelve weeks. The first four weeks focus on wound care, swelling control, and passive mobilisation using protocols such as Duran, with exercises every two hours.
Weeks four to eight add active assisted exercises, tendon gliding, and grip strengthening. Weeks eight to twelve progress to strengthening with balls and functional tasks.
Splinting is gradually reduced: wrist and finger positions are adjusted every two weeks until the splint is removed after week eight.
Studies assessing outcomes at six months using the Strickland classification found excellent results in 21%, good in 45%, fair in 12%, and poor in 22% of patients. Grip strength was rated good in 64% at six months.
- Grip strength was rated good in 64% at six months.
A common belief
Many expect a quick return to normal, but the tendon heals slowly.
What actually happens
Research shows therapy runs daily for twelve weeks, with splint changes every two weeks. At six months, only about two-thirds achieve good or excellent motion, and 64% have good grip strength. Rushing the process risks rupture.
Your next step at Jaipur Hospital
You will attend regular hand therapy sessions and follow a home exercise programme. The splint must be worn exactly as instructed. Do not force movements beyond what the therapist allows. Full return to heavy manual work may take longer than three months.
How will tendon, nerve, or muscle damage be assessed after hand tendon repair?
In short
After hand tendon repair at Jaipur Hospital, assessment is done at set intervals by the surgical team and hand therapists. They check active and passive range of motion, tendon gliding, grip strength, and sensation. Formal scoring systems such as the Strickland classification for total active motion and the American Society of Hand Therapists protocol for grip strength are used at six weeks, three months, and six months.
In detail
Evidence from outcome studies shows patients are evaluated at eight, ten, and twelve weeks, with final assessment at six months. The Strickland classification calculates total active motion as a percentage of normal.
Grip strength is measured with the elbow at ninety degrees, wrist in thirty degrees extension, using a dynamometer. Sensation is tested for nerve recovery using two-point discrimination and Semmes-Weinstein monofilaments. Muscle bulk and tone are observed.
In one study, Strickland results at six months were excellent in 21%, good in 45%, fair in 12%, and poor in 22%. Grip strength was good in 64%. These objective measures guide therapy progression and decide if tenolysis or further surgery is needed.
- Grip strength was good in 64%.
A common belief
Patients often go by feel, but objective scores guide decisions.
What actually happens
The Strickland classification gives a percentage of normal motion. Grip strength is tested in a set position. Nerve recovery is tracked with two-point discrimination. Studies show at six months only 21% achieve excellent motion and 64% good grip. These numbers tell us if more therapy or tenolysis is needed.
Your next step at Jaipur Hospital
You will attend regular therapy sessions where these measurements are taken. The therapist will teach you the exercises for each phase. Your surgeon reviews the scores at follow-up visits. If stiffness or weakness persists, the plan is adjusted.
How will appearance, function, and realistic expectations be discussed for hand tendon repair?
In short
At Jaipur Hospital, your surgeon will discuss appearance, function, and realistic expectations during the preoperative consultation. The surgeon explains the likely range of motion, grip strength, and any visible scar or contour change. You will receive a clear picture of what the hand can achieve after rehabilitation.
In detail
The discussion is based on evidence from zone two repair studies showing over 80 percent good or excellent outcomes, but also that fair or poor results occur in about one-third of patients.
The surgeon explains the phased rehabilitation timeline: splinting for eight weeks, therapy for twelve weeks, and full strength at three months. Potential complications such as adhesion formation (around four percent), rupture (around four percent), and the possible need for tenolysis are outlined.
If a nerve was also injured, the slow and uncertain nature of sensory recovery is explained. The surgeon also describes the surgical scar, which is usually on the palm or finger volar aspect, and any temporary swelling or stiffness. This informed consent process ensures you understand the commitment required for therapy.
A common belief
Some patients assume the hand will be normal in weeks.
What actually happens
The surgeon makes clear that three months of therapy is needed and one-third may have only fair motion. Honest expectations improve satisfaction.
Your next step at Jaipur Hospital
You will have time to ask questions before signing the consent form. The hand therapist may also join the discussion to explain the exercise regimen. Bring a family member or attendant if you wish.
Why might my doctor recommend hand tendon repair?
In short
A doctor at Jaipur Hospital may recommend hand tendon repair when a tendon is completely cut or ruptured so that you cannot bend or straighten one or more finger joints. Without surgical repair the tendon ends will not rejoin on their own and the finger will remain stuck in a straight position, causing long-term loss of hand function.
In detail
Tendons are the cords that connect forearm muscles to finger bones. When a deep cut or sudden force snaps a tendon, the muscle pulls the cut end away and the gap fills with scar tissue.
Evidence shows that early repair within two weeks gives the most suitable chance of restoring glide and strength. Delayed or chronic injuries may need a tendon graft or later tenolysis to release adhesions. The goal is to return active motion so you can grip, pinch and use the hand for daily tasks.
A common belief
Some patients hope that rest or physiotherapy alone will fix a cut tendon.
What actually happens
That is not possible because the muscle pulls the cut ends apart. Only microsurgical stitching can bridge the gap, and the sooner it is done the better the result.
Your next step at Jaipur Hospital
Your surgeon will examine the finger for loss of active flexion or extension, check the wound, and may order an ultrasound to confirm the tendon gap. If repair is advised, surgery is scheduled promptly. After the operation you will follow a protected motion programme for six weeks and strengthening for three months.
How should I prepare in the days before hand tendon repair?
In short
In the days before hand tendon repair at Jaipur Hospital, keep the hand clean and protect the injured finger from further trauma. Stop smoking if you can, as it impairs tendon healing. Arrange for an attendant to stay with you on the day of surgery and help at home afterwards. Follow any specific medication advice given by your surgeon.
In detail
Good skin condition reduces infection risk. Avoid cuts, burns or insect bites on the operative hand. If you take blood thinners, diabetes medicines or herbal supplements, the surgeon will tell you which to pause and when. Eat a balanced diet and stay hydrated.
Prepare loose clothing with wide sleeves that fit over a bulky dressing. Have ice packs and pillows ready at home for elevation. The physiotherapy team may give you a pre-operative appointment to teach splint care and the first exercises. Evidence shows that patients who understand the rehabilitation protocol before surgery cope better with the splint and exercise routine.
A common belief
Many people ignore the smoking advice.
What actually happens
Smoking reduces blood flow to the healing tendon and increases the risk of rupture. Even cutting down helps.
Your next step at Jaipur Hospital
Confirm your admission time with the hospital. Bring your test reports, insurance cards and a list of current medicines. Do not wear jewellery or nail polish on the operative hand.
What factors could make hand tendon repair riskier for me?
In short
Several factors can increase the risk of complications after hand tendon repair at Jaipur Hospital. These include the zone of injury, especially zone II where tendons pass through a tight sheath, the time between injury and repair, the presence of associated fractures or nerve injuries, and patient factors such as smoking, diabetes, or poor compliance with splinting and therapy.
In detail
Evidence indicates that early injuries repaired promptly tend to have better outcomes than late presentations. The study data showed early ruptures had a higher overall complication rate than late injuries, but delayed repair in scarred tissue is also challenging.
Associated fractures and nerve injuries were exclusion criteria in some outcome studies because they worsen prognosis. Smoking impairs wound and tendon healing. Diabetes can delay recovery and increase infection risk.
The type of rehabilitation protocol matters: early passive motion has a statistically lower rupture risk than early active motion but a higher risk of postoperative stiffness. Your surgeon will assess all these factors before planning surgery.
A common belief
People often think only the surgery matters, but when you have surgery and how you follow rehabilitation are just as important.
What actually happens
Studies show early passive motion has lower rupture risk than early active motion but more stiffness. Smoking and diabetes slow healing. Your surgeon weighs all these before operating.
Your next step at Jaipur Hospital
At your consultation, the surgeon will examine your hand, review any imaging, and discuss your medical history. They will explain how these factors apply to you and what can be done to minimise risk, such as optimising blood sugar control or stopping smoking before surgery.
Which symptoms are expected after hand tendon repair, and which need urgent medical attention?
In short
After hand tendon repair at Jaipur Hospital, expected symptoms include swelling, bruising, mild to moderate pain at the wound, stiffness, and a sensation of tightness when moving the fingers within the allowed range. These improve gradually with therapy and elevation.
In detail
Evidence shows patients can expect some residual digital stiffness following flexor tendon sheath infection even with prompt treatment. The Kanavel cardinal signs help differentiate infection: uniform finger swelling, flexed posture, tenderness along the tendon sheath, and pain on passive extension.
Sudden loss of active finger movement, a snapping sensation, or inability to bend the finger may indicate tendon rupture. Increasing redness, warmth, throbbing pain, fever, or pus from the wound suggest infection. Numbness or tingling that worsens may signal nerve compression. The incidence of rupture after flexor tendon repair was 4% and re-operation 6% in reported series.
A common belief
Patients often think any pain means something is wrong.
What actually happens
Some pain and stiffness are expected during rehabilitation. The dangerous signs are mechanical — a snap or sudden inability to bend the finger — or signs of infection like fever and spreading redness.
Your next step at Jaipur Hospital
Keep the hand elevated above heart level for the first few days. Take prescribed pain medication as directed.
If you notice sudden inability to move a finger, a popping feeling, spreading redness, fever above 38°C, or worsening numbness, contact the hospital immediately or visit the 24×7 emergency department. Do not wait for the next scheduled appointment.
FAQ library
Questions and answers about hand tendon repair
When you contact us
Get your hand assessed
Contact Jaipur Hospital for a consultation with a plastic surgeon, in-house tests, a clear explanation of options and a cost estimate before you decide.
- A consultation with a plastic surgeon in the OPD
- Your scans and reports reviewed, with tests done in-house if you need them (laboratory, X-ray and imaging)
- Your options explained in plain words, including whether you need surgery at all
- A cost estimate before you decide
- Help with cashless treatment under RGHS, MAA Yojana, CGHS and empanelled insurers and TPAs
- Follow-up visits after your treatment
Overview
Hand Tendon Repair: what to know
What hand tendon repair is and how the injury happens
- Flexor tendon cut
- Palm side cut bends fingers
- Extensor tendon cut
- Back of hand cut straightens fingers
- Closed rupture
- Tendon snaps without open wound
- Repair timing types
- Primary, delayed primary, graft
Tendons are the strong cords that connect muscles in your forearm to the bones in your fingers and thumb. When you bend or straighten your fingers, these tendons slide through protective tunnels called sheaths. A cut on the palm side of your wrist, hand or fingers can sever a flexor tendon, which bends the fingers.
A cut on the back of the hand or fingers can sever an extensor tendon, which straightens them. A tendon can also rupture without an open wound, for example when a finger is forced straight while you are trying to bend it hard, or in people with rheumatoid arthritis where the tendon wears down over time.
When a tendon is completely cut or torn, the muscle pulls the cut end back up the forearm, so the tendon ends no longer meet. The finger cannot bend or straighten on its own. Microsurgical repair stitches the cut ends back together using fine sutures under an operating microscope or surgical loupes.
The aim is to restore the smooth gliding of the tendon inside its sheath so you can move your finger again.
The surgery is called primary repair when it is done within the first 24 hours after the injury. If the repair is done within two weeks and the tissue is still healthy, it is called delayed primary repair.
When the injury is older than a few weeks and the tendon ends have retracted or the sheath is scarred, a tendon graft may be needed in two stages. If the repaired tendon becomes stuck down by scar tissue later, a separate operation called tenolysis can release the adhesions.
Symptoms of a cut or ruptured hand tendon and when to seek urgent care
- Cannot move finger after cut Open cut on palm, wrist or fingers
- Heavy bleeding from deep cut Bleeding that does not stop
- Numbness or tingling in fingertips May mean nerve is also cut
- Finger in abnormal position Lies differently to other fingers
- Closed rupture with no movement Skin intact but tendon snapped
The most common sign is that you cannot bend one or more joints of a finger or thumb, or you cannot straighten them, depending on which tendon is injured. You may also feel pain when you try to move the finger, and some people describe a rubbing or snapping sensation with movement.
If the injury is an open cut on the palm, wrist or fingers and you cannot move the finger normally, you should attend the emergency department the same day.
Other reasons to seek care immediately include:
- A deep cut that is bleeding heavily
- Numbness or tingling in the fingertips (which may mean a nerve is also cut)
- A finger that lies in a different position to the others
A closed rupture — where the skin is intact but the tendon has snapped — also needs prompt assessment because early repair gives a better result.
Causes of hand tendon injury and who is at higher risk
- Sharp cuts
- Knife, glass, metal, machinery
- Forced straightening while gripping
- Sports jersey catch or pulling object
- Metal plate rubbing tendon
- Distal radius fracture plate causes late rupture
- Rheumatoid arthritis
- Inflames sheath and weakens tendon
- Bone conditions
- Hereditary multiple exostoses
- Smoking and diabetes
- Slow healing after repair
Most tendon injuries are caused by a sharp cut from a knife, glass, metal sheet or machinery. A tendon can also rupture when a finger is forced straight while you are gripping hard, such as catching a jersey in sport or pulling a stubborn object.
In the wrist, a metal plate fixed for a distal radius fracture can rub on the flexor pollicis longus tendon and cause it to rupture months or years later.
People with rheumatoid arthritis are at higher risk because the disease inflames the tendon sheath and weakens the tendon itself. Certain bone conditions such as hereditary multiple exostoses can also lead to tendon irritation and rupture.
Smoking and diabetes can slow healing after repair, and not following the splinting and exercise programme increases the chance of the repair breaking or becoming stiff.
How a hand tendon injury is diagnosed: examination and tests
Your surgeon will ask how the injury happened and examine your hand. They will test each joint to see if you can bend and straighten it actively. They will also check the feeling in your fingertips and the blood supply to the finger. The pattern of which joints do not move helps locate the level of the tendon injury.
If the wound is open, the diagnosis is often clear from the examination alone. An X-ray may be taken to check for a fracture or a foreign body such as glass. Ultrasound or MRI can show a tendon rupture when the skin is intact, or assess the gap between tendon ends in a chronic injury.
These scans are not routine for every case; your surgeon will order them only if the examination does not give a clear answer.
Non-surgical treatment options and when surgery is advised for hand tendon repair
A completely cut or ruptured tendon will not heal on its own because the cut ends pull apart. Surgery is the standard treatment to restore movement.
In a few specific situations — such as a partial tear where the tendon is still mostly intact, or when a patient is too unwell for anaesthesia — the hand may be splinted and managed with careful hand therapy. This decision is made only after a specialist assessment.
Surgery is advised when the tendon is completely divided, when a rupture leaves you unable to use the finger for daily tasks, or when a partial tear does not improve with splinting. The timing depends on the type of injury. Primary repair within 24 hours is ideal. Delayed primary repair up to two weeks is also common.
For older injuries with tendon loss, a two-stage tendon graft may be planned. Your surgeon will explain which approach suits your injury and the condition of the tissues.
Preparing for Hand Tendon Repair
Do
- Bring list of all medicines
- Stop certain medicines if told
- Fast for at least six hours
- Wear loose clothing with wide sleeves
- Arrange attendant for 24 hours
Avoid
- Leave jewellery and valuables at home
Your surgeon will explain the operation and ask about your general health. Bring a list of every medicine you take, including blood thinners, aspirin, or supplements. Some medicines may need to be stopped a few days before the procedure; your doctor will tell you which ones.
If you have diabetes, high blood pressure, or a heart condition, the anaesthesia team may ask for recent blood tests, an ECG, or a chest X-ray. You will be asked to fast for at least six hours before the operation, usually from midnight if the surgery is in the morning.
Wear loose clothing with wide sleeves that can fit over a bulky dressing. Arrange for an attendant to take you home and stay with you for the first 24 hours, because you cannot drive after regional or general anaesthesia. Leave jewellery and valuables at home. The hospital provides a gown and a locker for your belongings.
How Hand Tendon Repair Is Done
- Primary repair
- Direct stitch within 24 hours
- Delayed primary repair
- Within two weeks if tissue healthy
- Tendon graft
- Two-stage using palmaris longus
- Tenolysis
- Releases scar tissue adhesions
- Epitendinous suture benefit
- Decreases re-operation chance by 84 percent
The operation usually takes one to two hours under regional or general anaesthesia. Your surgeon will choose the technique that fits the injury and the time since it happened. Primary repair means the cut tendon is stitched directly, usually within 24 hours of the injury. Delayed primary repair is done within two weeks when the tissue is still healthy.
If the gap between tendon ends is too long or the injury is old, a tendon graft may be needed; this is often a two-stage reconstruction using a tendon from another part of your body, such as the palmaris longus.
Tenolysis is a separate operation to release scar tissue that sticks the healed tendon to surrounding structures and stops it gliding. During the repair, the surgeon uses strong multi-strand core sutures and a finer epitendinous suture around the outside; the epitendinous suture has been shown to decrease the chance of re-operation by 84 percent.
The surgeon may also release the critical pulleys over a short length, which is considered safe and helps recovery. After the repair, the wound is closed and a plaster splint is applied to keep the wrist and fingers in a protected position.
You will go home the same day or stay one night, depending on the time of surgery and your comfort.
Risks and Possible Complications of Hand Tendon Repair
- about 4 percent Rupture after flexor repair
- about 6 percent Re-operation incidence
- about 4 percent Adhesion incidence
- by 57 percent Modified Kessler lowers adhesions
- about 5 percent Early active motion rupture rate
Every operation carries risks. The main ones after tendon repair are rupture of the repair, stiffness from adhesions, and infection. In studies, the incidence of rupture after flexor tendon repair was about 4 percent, and the incidence of re-operation was about 6 percent.
Adhesion formation remains a common complication even with careful repair; the reported incidence of adhesions was about 4 percent. Using a modified Kessler technique can lower adhesion development by 57 percent.
Early active motion protocols have a rupture rate of about 5 percent in large series, while early passive motion protocols show a lower rupture risk but a higher chance of stiffness.
Infection in the tendon sheath can lead to lasting stiffness; patients with other medical problems or who present late with advanced infection may have poorer outcomes, including severe stiffness or, rarely, amputation. Nerve injury during surgery is uncommon but can cause numbness or weakness. Your surgeon will discuss the risks that apply to your injury and the chosen technique.
Recovery and Aftercare After Hand Tendon Repair
- Weeks 4 to 8 Active exercises: tendon gliding, grip strengthening, finger abduction and adduction
- Three months Full strength returns, protected motion for six weeks
You will wear a dorsal splint that holds the wrist in 30 to 40 degrees of flexion, the knuckles at 60 to 70 degrees, and the finger joints straight for the first four weeks.
The splint is changed at four to six weeks to allow a little more wrist and knuckle movement, and again at six to eight weeks with the wrist neutral. After eight weeks the splint is usually removed. Keep your hand raised above heart level as much as possible for the first few days to reduce swelling.
Keep the dressing dry and clean; do not remove the splint yourself. A hand therapist will start gentle exercises on the first day after surgery. The first phase (weeks 0 to 4) uses passive movements: you use your other hand to bend each finger down to the palm and straighten them, following a Duran-type protocol every two hours.
Pain control may include simple analgesics and sometimes TENS. From week 2 to 3, light massage helps prevent skin adhesions. The second phase (weeks 4 to 8) adds active exercises such as tendon gliding, grip strengthening, and finger abduction and adduction. The third phase (weeks 8 to 12) continues strengthening with a ball for hand and forearm muscles.
Protected motion continues for six weeks; full strength takes about three months. Do not make any other hand movements that could break the repair. Contact the hospital if you notice increasing pain, redness, swelling, discharge, sudden snapping sensation, or fever.
Results of Hand Tendon Repair
Modern repair and rehabilitation methods lead to markedly more reliable repairs. In studies of zone 2 repairs, over 80 percent of patients achieve good or excellent outcomes, and results are not dissimilar to repairs in other zones.
One large series using the Strickland classification found excellent results in 21 percent, good in 45 percent, fair in 12 percent, and poor in 22 percent at six months. Grip strength was rated good in about 64 percent of cases. Rupture rates have decreased significantly over time in published literature.
The median interval to rupture, when it occurs, is around nine months. The flexor pollicis longus (thumb tendon) is the most commonly ruptured tendon in reported series. Your surgeon will explain what outcome is realistic for your specific injury, the zone involved, and how well you can follow the therapy programme.
Cost and Insurance for Hand Tendon Repair in Jaipur
The typical price range for hand tendon repair in India is ₹35,000 to ₹90,000. The final cost depends on the type of repair (primary, delayed, or graft), the anaesthesia used, whether you stay as daycare or overnight, and any implants or grafts required. Jaipur Hospital is a NABH-accredited multispeciality hospital established in February 1991.
We accept RGHS, MAA Yojana, CGHS, and a panel of private insurers and TPAs. The hospital has a 24×7 emergency department, in-house pharmacy, diagnostic laboratory, imaging, and modular operation theatres. For a personal estimate, please contact the hospital on 0141-2551500, 0141-2554139, or 7414 001 001, or email [email protected].
