Tendon Lacerations

Tendons are the strong, fibrous tissues that connect our muscles to our bones. They play a crucial role in allowing us to move and perform tasks with precision, and none more so than those tendons within our hands. However, a tendon laceration can disrupt this harmony, and when these essential structures within the hand are torn or cut, it can make for an extremely painful and disruptive situation that has a profound impact on one’s life.

Prior to 1950 if you lacerated the flexor tendons in your fingers – with a knife, bayonet, or a lawnmower – you would have to accept a bad result. Thanks to a few very gifted surgeons in the USA – notably Dr Stirling Bunnell, Dr Harold Kleinert and others – the concept of tendon repair and tendon rehab protocols has flourished and then given rise to hand surgery as a new and separate sub-specialty of surgery over the last 70-75 years.

At the Sydney Orthopaedic Surgeon Clinic, we understand the challenges posed by tendon lacerations in the hand, and we’re here to provide the expert care you need to regain control. Leading our clinic is Dr Stuart Kirkham, a vastly experienced and extremely well-respected orthopaedic surgeon and distinguished hand specialist. During his extensive training in the USA, Dr Kirkham met Dr Kleinert in what was an invaluable experience, helping him hone his skills and deliver tailored and compassionate care to each patient.

Whether your tendon laceration is a minor issue or a more complex case requiring surgical intervention, Dr Kirkham can offer a highly effective diagnosis, treatment, and aftercare plan designed to meet your unique needs. No matter the nature of your injury, our dedicated team is ready to provide the care and support you require on your journey to recovery.

If you find yourself concerned about a tendon laceration in your hand, we urge you not to delay seeking help. Take the first step towards healing and a better quality of life by reaching out to us today. Schedule a consultation with Dr Kirkham at one of his many conveniently located Sydney clinics and let him assist you in restoring the comfort and function of your hand.

Anatomy Affected by Tendon Lacerations

The hand is a highly intricate network of bones, joints, muscles, ligaments and tendons, which all work in harmony to facilitate a wide range of movements that are essential to our everyday lives. At the heart of the anatomical structure lies the tendons, which are robust cords of connective tissue that join muscles and bones, making sure the hand can conduct precise movements.

Within the hand’s anatomy, there are several different tendons at work, but the flexor and extensor tendons play particularly important roles. The flexor tendons, situated on the palm side of the hand, are responsible for the graceful curling of fingers, making intricate tasks like grasping objects and typing possible. In contrast, extensor tendons, located on the back of the hand, allow for the opposite motion, helping to straighten the fingers and the wrist.

Tendons act as critical connectors between the muscles and the bones. When you flex or extend your fingers, it’s the tendons that transmit the force generated by the muscles to the bones, creating coordinated and precise motions. This remarkable interplay of tendons is what grants us the dexterity to perform everyday activities, from tying shoelaces to holding a pencil.

However, when a tendon laceration occurs, this finely tuned system is disrupted. Imagine a snapped guitar string in the middle of a concert. If a flexor tendon in the palm of the hand sustains a laceration, you may not be able to bend your fingers. Conversely, when an extensor tendon on the top of the hand sustains a laceration, you may not be able to straighten your fingers. Any laceration, regardless of its type, can lead to a range of issues, including loss of mobility, pain, and difficulty in executing even the simplest of tasks.

If you suspect a tendon laceration in your hand or want to learn more about how this intricate anatomy might be impacted, don’t hesitate to contact Dr Kirkham. An examination and consultation with him can provide valuable insights into your hand’s unique structure and any potential issues that may arise from a tendon laceration. Reach out today to discover how we can help you regain the fluidity and grace of hand movements you once enjoyed. Your journey to understanding and healing starts here.

Causes and Risk Factors for Tendon Lacerations

Tendon lacerations in the hand can occur as a result of accidents, sharp object injuries, sports-related incidents, and even mundane kitchen mishaps. Picture a slip with a knife while preparing a meal, a fall from a bicycle during a leisurely ride, or a momentary lapse of concentration while operating power tools – these are common scenarios that can lead to tendon lacerations. In essence, tendon injuries can happen when we least expect them, turning routine activities into potential sources of harm.

Certain risk factors can increase the likelihood of sustaining a tendon laceration. Occupational hazards in industries like construction or manufacturing may expose individuals to machinery and tools that pose an increased risk of hand injuries. Engaging in certain sports activities, like contact sports or those involving high-speed projectiles, can also heighten the chances of sustaining hand injuries. In some cases, the absence of adequate protective gear can leave individuals vulnerable to tendon lacerations.

Yet, what makes tendon lacerations particularly challenging is that they can be difficult to avoid entirely. Even the most cautious individuals may find themselves in situations where a momentary lapse in concentration or a split-second accident leads to injury. Additionally, certain health conditions, such as rheumatoid arthritis, can weaken the flexor tendons, making them more susceptible to tearing or rupturing. Interestingly, these tendon injuries can occur without any apparent trauma or warning signs. An individual might suddenly realise that their finger no longer bends as it should, without any recollection of how the injury happened.

In specific extensor tendon injuries, mallet Finger, for instance, results in the drooping of the end-joint of a finger when an extensor tendon is cut or torn from the bone. This often occurs when an object strikes the tip of the finger or thumb, forcefully bending it. Boutonnière Deformity, on the other hand, describes the flexed position of the middle joint of the finger, often stemming from a cut or tear of the extensor tendon.

If you suspect you’ve experienced a tendon laceration or are at risk due to your activities or health conditions, it’s crucial to seek professional advice and evaluation. Dr Kirkham at the Sydney Orthopaedic Surgeon Clinic is here to provide expert guidance and determine the best course of action for your specific situation. Don’t hesitate to reach out for an examination and personalised care.

Symptoms and Identification of Tendon Lacerations

Recognising the symptoms of tendon lacerations in the hand is crucial, but early identification can lead to more effective treatment and a smoother road to recovery. These injuries often manifest with a set of relatively obvious symptoms that indicate trauma has been endured by the tendons. Sharp and persistent pain is often accompanied by swelling, because the body’s natural response to injury is to increase blood flow and fluids to the affected site.

However, the most tell-tale sign of a tendon laceration lies in the limitation of movement. When a tendon is completely ruptured or lacerated, the ability to bend or straighten fingers can be significantly compromised. The extent of this impairment depends on the location of the injury, ranging from limited movement in a small area of the hand to the inability to move multiple joints in the arm. It’s a stark reminder of how intricately our tendons are intertwined with our daily functioning.

It’s important to note that symptoms can vary between flexor and extensor tendon injuries. Flexor tendons, which control the bending of the fingers, are located close to vital nerves and arteries. Consequently, lacerations in this area may result in numbness, tingling sensations, and significant bleeding. In contrast, extensor tendon injuries, which allow the fingers to straighten, may present with different signs, such as an open injury on the palm side of the hand, an inability to bend finger joints, pain upon attempting to bend the fingers, tenderness along the palm side, and even numbness in the fingertip.

If you suspect that you’re suffering from a tendon laceration and experience changes in arm function or any of the described symptoms, seeking medical attention is crucial. Dr Kirkham at the Sydney Orthopaedic Surgeon Clinic is ready to provide expert evaluation and guidance tailored to your specific needs. Don’t hesitate to reach out for a thorough examination and personalised care to address your concerns. Your hand’s well-being is his priority.

Diagnosis and Imaging of Tendon Lacerations

Diagnosing a tendon laceration requires a systematic approach to assess the extent of the injury and determine the most appropriate course of treatment. The process with a doctor after the injury has occurred typically begins with a combination of a physical examination and a thorough review of the patient’s medical history. These initial steps help healthcare professionals gather essential information about the injury, including its cause, symptoms, and any relevant pre-existing conditions.

In cases of severe lacerations or injuries to the hand or fingers, immediate first aid measures are crucial. These steps can provide temporary relief and mitigate potential complications before seeking professional medical attention. Applying a compression wrap with a clean cloth or bandage can help slow down bleeding, reducing the risk of excessive blood loss. Coating the wound with sterile saline is essential to minimise the chances of infection, particularly in cases where the injury exposes the internal structures of the hand. Applying ice or a cold pack can assist in reducing swelling, which is a common reaction to trauma. Elevating the injured hand above the heart level further aids in minimising swelling.

However, it’s important to remember that these first-aid measures are not substitutes for professional medical evaluation and treatment. Seeking medical care as soon as possible is crucial, especially for serious hand or finger lacerations. Depending on the severity of the injury, it may be appropriate to visit an urgent care centre or an emergency room. A healthcare provider will assess the hand for potential damage to tendons, nerves, blood vessels, or bones. Additionally, a tetanus injection or antibiotics might be recommended to prevent infection, as open wounds are susceptible to bacterial contamination.

To assess the possibility of bone involvement, an X-ray may also be conducted to examine the bones of the hand, wrist, or forearm. This diagnostic tool aids in identifying any fractures or structural damage that may have occurred as a result of the injury.

If you suspect a tendon laceration or have experienced a hand injury, it’s essential to consult a specialist like Dr Kirkham at the Sydney Orthopaedic Surgeon Clinic. His expertise in hand injuries and thorough evaluation can provide you with the precise diagnosis and tailored treatment plan necessary for your recovery. Don’t delay in seeking professional care to ensure the best possible outcome for your hand health.

Treatment Options for Tendon Lacerations

When faced with a tendon laceration in the hand, timely and appropriate treatment is crucial to optimise the chances of a successful recovery. After a thorough examination by your doctor, several treatment options may be considered, depending on the nature and severity of the injury.

First and foremost, your doctor may initiate treatment by cleaning any open wounds and closing them to minimise the risk of infection. Additionally, if there is dead tissue present, it may be carefully removed to promote proper healing. To manage pain and inflammation, your doctor may prescribe pain medication and anti-inflammatories as part of your treatment plan. Furthermore, splinting may be necessary to immobilise and protect the injured structures, aiding in the healing process.

It’s essential to understand that tendons cannot naturally heal unless their severed ends are brought into close proximity. In most cases of a cut or torn tendon, surgical intervention by a skilled surgeon is required to restore functionality and prevent long-term impairment.

Surgery for tendon lacerations is typically performed within 7 to 10 days after the injury. The timing of the procedure is critical, as early surgical intervention often yields better recovery outcomes. However, if the injury is severe enough to restrict blood flow to your hand or finger, immediate surgery may be necessary to prevent further complications.

Tendon lacerations present diverse patterns of injury, such as straight cuts, angled tears, or detachment from the bone. Consequently, there are various surgical methods employed by your surgeon to repair these injuries, often involving specialised sutures or stitches. To protect the repair and ensure optimal healing, your fingers and wrist may be positioned in a bent posture to reduce tension on the injured structures.

The success of the repair and the restoration of hand function is often directly linked to your adherence to your Dr Kirkham’s post-operative instructions. If you suspect that you have experienced a tendon laceration or have undergone a hand injury, it is crucial to consult with a specialist like Dr Kirkham at the Sydney Orthopaedic Surgeon Clinic. His expertise and guidance will ensure you receive the appropriate treatment and support tailored to your unique needs, setting you on the path to recovery.

Recovery and Aftercare for Tendon Lacerations

Recovery from a tendon laceration in the hand unfolds in distinct stages, each with its unique challenges and milestones.

Immediately after surgery, your hand enters a phase of initial healing and protection. Surgical intervention aims to restore the integrity of the injured tendons, and this early stage focuses on safeguarding the repair. Following surgery, you may be introduced to a hand therapist who will guide you through post-surgical exercises. These exercises serve a dual purpose: they protect the tendon repair while encouraging the tendons to glide smoothly within the tendon sheath, promoting flexibility and functionality.

The rehabilitation period that ensues is a critical phase where gradual progress is made. For a flexor tendon injury, it typically takes approximately 3 to 4 months for the hand to heal sufficiently, allowing it to be strong enough for everyday use without restrictions. During this period, you will likely wear a protective splint for around 6 to 8 weeks after surgery. The splint is removed only when you engage in exercises prescribed by your doctor and therapist. These exercises play a pivotal role in gradually regaining motion and function in your hand.’

Splint worn when recovering from a tendon laceration

It’s common to experience stiffness after surgery, but this usually responds well to therapy. However, in some cases, scar tissue may develop, causing the tendon to adhere to the tendon sheath. If conservative therapy doesn’t adequately resolve this issue, an additional surgical procedure known as tenolysis may be necessary. Tenolysis is typically performed once the tendon ends have healed well enough, approximately 4 to 6 months post-repair. This procedure helps free up the tendons, allowing them to glide freely within the tendon sheath and improving the movement of the injured finger or thumb.

Continued follow-up appointments with Dr Kirkham are important in allowing him to monitor your progress and make necessary adjustments to your treatment plan. The journey to full recovery can be influenced by various factors, including the severity of the injury, individual healing capabilities, and adherence to therapy. Your commitment to following the guidance of your surgeon and therapist is instrumental in achieving the best possible outcome.

For comprehensive and personalised support during your recovery from a tendon laceration, consult with Dr Kirkham at the Sydney Orthopaedic Surgeon Clinic. His expertise and guidance will help you navigate each stage of your rehabilitation journey, ultimately restoring the full functionality of your hand.

Possible Complications of Tendon Lacerations

While the goal of treating tendon lacerations is to restore function and minimise complications, it’s important to be aware of potential challenges that may arise during the recovery process.

Common complications that patients may encounter include infection, tendon adhesion, and overall joint stiffness. Infections can often occur in open wounds, and that’s why Dr Kirkham and all other medical professionals emphasise the importance of thorough wound care and the use of prescribed antibiotics if necessary. Tendon adhesion occurs when the healed tendons stick to surrounding structures, and this can limit movement and require additional therapy. Joint stiffness may also develop, impacting the hand’s flexibility and dexterity.

Long-term issues can include reduced hand function, and chronic, unrelenting pain. These challenges can persist if complications are not promptly addressed and if rehabilitation measures are not carefully followed. However, early treatment can prove vital in minimising these complications. Seeking prompt medical attention and adhering to Dr Kirkham’s recommended treatment plan can significantly reduce the risk of complications. Proper aftercare, including wound care, exercises, and splint wear, plays a pivotal role in achieving optimal recovery and preventing long-term issues.

With Dr Kirkham’s expertise and the commitment of his experienced team at the Sydney Orthopaedic Surgeon clinic, you can navigate your recovery with confidence, addressing any potential complications along the way and ensuring your hand returns to full function and restored health.

Are You Concerned About Tendon Lacerations?

If you find yourself concerned about the possibility of a tendon laceration in your hand, your worries are valid, and your well-being is our priority. Tendon lacerations can disrupt your daily life, causing pain and limitations in hand function. We understand the challenges you may face, and we’re here to offer support and guidance.

At the Sydney Orthopaedic Surgeon Clinic, under the care of Dr Kirkham, we specialise in addressing hand injuries, including tendon lacerations. Whether your concerns are driven by mild discomfort or more severe symptoms that affect your daily activities, rest assured that we are here to assist you on your path to recovery.

Your concerns are not to be dismissed lightly. Seeking professional advice is a crucial step in addressing tendon lacerations. Don’t hesitate to reach out to us today to schedule a consultation with Dr Kirkham. Together, we can take the first stride towards improved hand mobility, pain relief, and an enhanced quality of life. Our dedicated team is committed to providing a thorough assessment and crafting a personalised treatment plan tailored to your specific needs, ensuring that your concerns are addressed comprehensively.


1. What happens if a tendon laceration is left untreated?

Leaving a tendon laceration untreated can lead to significant consequences. Tendons that have been completely cut are unlikely to heal on their own and typically require surgical intervention to re-establish function. Without treatment, you may experience a permanent droop in the affected finger, leading to a severe deformity that interferes with normal hand function. Furthermore, untreated tendon lacerations may result in ongoing pain and limited mobility, significantly impacting your quality of life. It’s crucial to seek prompt medical attention if you suspect a tendon laceration to ensure the best possible outcome and prevent long-term complications.


2. What is a full-thickness laceration?

A full-thickness laceration is a deep wound that extends beyond the surface layers of the skin. These wounds penetrate through the outermost layers and delve into deeper tissues, potentially exposing subcutaneous (fatty) tissue, muscle, tendon, or even bone. Full-thickness lacerations are characterised by their severity and the extent of tissue damage. These injuries require careful evaluation and treatment, often involving surgical intervention to repair damaged structures. Proper management of full-thickness lacerations is crucial to ensure optimal healing, minimise complications, and restore the affected area’s functionality.


3. How long does a lacerated tendon take to heal?

The healing timeline for a lacerated tendon can vary depending on the severity of the injury, the specific tendon involved, and individual factors. In general, a repaired tendon will regain full strength after approximately 12 weeks. However, it may take up to 6 months to fully recover the complete range of motion in the affected hand or finger. In some cases, achieving the same level of mobility as before the injury may not be possible. The key to successful recovery is adhering to the recommended treatment plan, which often includes post-surgical exercises and therapy, to optimise healing and functional outcomes.


4. Can tendon lacerations heal without surgery?

Whether a tendon laceration can heal without surgery depends on the extent of the injury. If the tendon is completely severed, surgical repair is typically necessary. This surgery is usually performed within 7 to 10 days after the injury to ensure the best chances of recovery. The surgeon may close the wound with stitches, bandage it, and place the hand or finger in a splint during this time. However, for partial tendon lacerations, some cases may allow for healing without surgery, but this decision should be made by a medical professional. Regardless of the approach, it’s essential to consult a specialist like Dr Kirkham for proper evaluation and guidance to ensure the best possible outcome for your tendon injury.


5. How can I prevent tendon lacerations in everyday activities?

To minimise the risk of tendon lacerations in everyday activities, it’s essential to prioritise safety and take precautionary measures. Start by using appropriate safety equipment and ergonomic tools when engaging in activities that pose a potential risk, such as handling sharp objects or power tools. Wearing protective gear, such as gloves, can provide an added layer of protection. Additionally, be mindful of your surroundings and take care to avoid hazards that could lead to injuries. When participating in sports or physical activities, use proper techniques and adhere to safety guidelines to reduce the risk of accidents. If you have concerns about tendon laceration prevention in your specific daily activities, consult with a healthcare professional or specialist for personalised advice and recommendations.


  1. OrthoInfo (Flexor Tendon Injuries)
  2. American Society for Surgery of the Hand (Flexor Tendon Injury)