Realistic Expectations (Flexor Tendon Repairs)

Flexor tendon injuries are very serious and usually require prolonged postoperative hand therapy to reach maximal functional result. The length of hand therapy required will be very much dependent on the level of the flexor tendon injury. At some levels of injury of the flexor tendon, full range of motion is usually achieved. If sufficient scar tissue forms, a secondary operation to free the tendon from the scar tissue will be necessary and possibly a staged tendon reconstruction, whereby the tendon is removed and a plastic tendon spacer is placed for three months to allow formation of a new smooth surface canal. The next stage of staged tendon reconstruction requires this plastic tendon be removed and replaced with a tendon graft. Good results following flexor tendon injury are only achieved if the patient cooperates 100 percent with the surgeon and the hand therapist, following instructions implicitly. These are very serious injuries and perfectly normal range of motion is the exception and not the rule. Treatment by an inexperienced surgeon or poor patient compliance almost guarantees a poor result.