Tendons are cord-like structures that connect muscles to bones, enabling movement throughout the body. In the fingers, these structures are essential for intricate actions like bending and straightening. Finger tendons allow for grasping, pinching, and fine motor control, making their proper function important for daily tasks. An injury to these tendons can significantly impact hand function, so quickly identifying any potential damage is important.
Recognizing Potential Tendon Damage
Signs can indicate a potential tendon injury in a finger. A cut on the palm side or back of the finger is a common cause, as even a small laceration can sever a tendon. Significant pain at the wound site is often present. Swelling and bruising can also develop around the affected area.
A visible gap or an unusual resting position of the finger suggests a severed tendon. For instance, a finger with a cut flexor tendon might lie straighter than the others, unable to bend properly. Conversely, if an extensor tendon is damaged, the finger might be stuck in a bent position. If nerves are also affected, numbness, tingling, or a loss of sensation in the fingertip can occur.
Performing Self-Checks for Tendon Integrity
To assess the integrity of finger tendons, specific movements can be attempted. The fingers rely on two main groups of tendons: flexor tendons, which allow bending, and extensor tendons, which enable straightening. Checking each finger individually provides a clearer picture of potential damage.
For flexor tendons, which are located on the palm side of the hand, two simple tests can be performed. To check the flexor digitorum superficialis (FDS) tendon, hold all fingers except the one being tested flat against a surface or in full extension. Then, attempt to bend only the middle joint (proximal interphalangeal or PIP joint) of the isolated finger. If the FDS tendon is intact, the finger should be able to bend at this joint.
To assess the flexor digitorum profundus (FDP) tendon, which bends the fingertip, hold the middle joint (PIP joint) of the finger straight. With the middle joint stabilized, try to bend only the very tip of the finger (distal interphalangeal or DIP joint). An inability to perform these bending movements, or significant weakness and pain, suggests a flexor tendon injury.
For extensor tendons, located on the back of the hand, testing involves straightening the fingers. Place the hand palm-down on a flat surface. Attempt to lift each finger straight up off the surface one at a time. Another way is to try and straighten the finger against light resistance.
If an extensor tendon is cut, the finger may not be able to straighten fully, or it might remain noticeably bent at one of the joints. A lack of full movement or notable weakness indicates tendon damage.
Immediate Actions and Medical Consultation
If a tendon injury is suspected, immediate action and medical attention are important. Clean the wound gently with soap and water to reduce infection risk. Apply direct pressure with a clean cloth or bandage to control bleeding. Elevating the injured hand above the heart can minimize swelling. Apply ice or a cold pack for 10 to 20 minutes at a time, with a thin cloth barrier, to reduce swelling and pain.
Seeking medical evaluation quickly is important. Tendon injuries, especially complete cuts, typically require surgical repair. Ideally, repair should occur within 7 to 10 days for favorable outcomes. If there is concern about blood flow to the finger, or if a significant portion of the finger is severed, immediate emergency medical attention is necessary. Early intervention can improve recovery and restore hand function.