Fair Oaks Orthopedics

Your hands have tendons, which are tough cords of tissue that form a physical connection between your muscles and the bones in your hands. When a group of your hand muscles tightens, the attached tendons will pull on the bones, allowing you to make hand movements.

There are two groups of tendons in your hand:

  • The Extensor Tendons run from your forearm across the back of your hand to your fingers and thumb, which allows you to straighten them.
  • The Flexor Tendons run from your forearm through your wrist and across the palm of your hand, which allows you to bend your fingers.

Depending on the type of injury, hand ligament injury can often be used to repair damage to both of these groups of tendons.

hand ligament injury, Dupuytren's Contracture Treatment
hand ligament injury

Dr. Stephen W. Pournaras is dedicated to providing exceptional care for hand tendon and ligament injuries and conditions from diagnosis to recovery. If you have a hand injury or chronic condition, please get in touch with us at Fairoaks Ortho. Dr. Pournaras & our staff considerably understand the complex network of blood vessels, nerves, muscles, ligaments, tendons, and bones that make up your hand and fingers.

Hand Ligament injury surgery involves making an incision in your wrist, hand, or finger to locate the ends of a divided tendon and stitch them. This surgery helps restore movement in the affected fingers or thumb.

Hand Ligament injury surgery involves cleaning up the damaged tissue or repairing the tear with sutures anchored to the bone.

After your surgery, a splint will your wrist and hand in position that gently stretches the repaired tendon or ligaments to prevent tightness and scar tissue. Therapy after ligament or tendon surgery is vital to your recovery.

Your hands have ligaments crucial in stabilizing the joints and creating smooth movements. They connect bones to bones and help maintain the structure of the hand. These are the main ligaments of the hand:

Collateral Ligaments: These are located on the sides of the finger joints (proximal and distal interphalangeal joints) and the thumb joint (metacarpophalangeal joint). They help secure the joints and prevent excessive sideways movement.

Palmar Radiocarpal Ligament: Hand Ligament injury spans the palmar side of the wrist joint (radiocarpal joint) and helps secure the wrist during movements such as bending and extending.

Dorsal Radiocarpal Ligament: Similar to the palmar radiocarpal ligament, this ligament is located on the back side of the wrist joint and provides stability during wrist movements.

Interosseous Ligaments: Hand Ligament injury connect adjacent bones in the hand and wrist, providing stability and support to the various joints. They include the intercarpal ligaments between the carpal bones in the wrist and the intermetacarpal ligaments between the metacarpal bones in the palm.

Triangular Fibrocartilage Complex (TFCC): While not strictly a ligament in the traditional sense, the TFCC is a structure made up of ligaments and cartilage that stabilizes the ulna (one of the two forearm bones) and supports the wrist joint. It helps transmit forces from the hand to the forearm and provides stability during gripping and twisting movements.

 

These ligaments work together to maintain the stability and functionality of the hand and wrist. Injuries to these ligaments, such as sprains or tears, can result in pain, swelling, instability, and reduced range of motion.

In severe cases, surgery may be necessary to repair or reconstruct the damaged ligaments and restore hand function.

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Hand tendon repair surgery is done to restore the function of the hand and correct the damaged tendons. When a tendon is injured or torn, it can significantly impact your hand function, leading to weakness, limited range of motion, and pain.

Hand tendon repair surgery involves the following steps:

Evaluation: Before surgery, Dr. Pournaras will assess the extent and location of the tendon injury through physical examination and imaging studies such as MRI or ultrasound.

Anesthesia: The surgery is performed under local anesthesia with sedation or general anesthesia to ensure your comfort during the procedure.

Incision: Dr. Pournaras will make an incision over the injured tendon, exposing the damaged area.

Repair: The torn or injured tendon is then repaired using various techniques depending on the nature and severity of the injury. This may involve suturing the torn ends of the tendon together (primary repair) or using grafts or other tissue substitutes to bridge the gap if the tendon ends cannot be directly reattached. The goal is to restore continuity and strength to the tendon.

Closure: Once the repair is completed, the incision is closed with sutures or surgical staples.

Postoperative Care: After surgery, the hand is typically immobilized with a splint or cast to protect the repaired tendon as it heals. Physical therapy and rehabilitation exercises are often prescribed to gradually restore strength, flexibility, and function to the hand. The rehabilitation process may involve a gradual progression of exercises to prevent stiffness and promote optimal healing of the repaired tendon.

Recovery from hand tendon repair surgery can vary depending on the extent of the injury and the patient’s overall health. It may take several weeks to months for full recovery, during which time the patient may need to avoid certain activities. Most patients experience significant improvement in hand function and pain relief following surgery.

Hand ligament repair surgery is done to repair damaged or torn ligaments in your hand. When a ligament is injured or torn, it can lead to instability, weakness, and pain in the affected joint.

  1. Evaluation: Before surgery, Dr. Pournaras will assess the extent and location of the ligament injury through a physical examination and imaging studies such as X-rays, MRI, or ultrasound.
  2. Anesthesia: This surgery is performed under regional or general anesthesia to ensure your comfort.
  3. Incision: Dr. Pournaras will make an incision over the affected joint to access the damaged ligament.
  4. Repair: The torn or injured ligament is then repaired using various techniques depending on the nature and severity of the injury. This may involve reattaching the torn ends of the ligament using sutures or reconstructing the ligament using grafts or other tissue substitutes if the ligament is severely damaged. The goal is to restore stability and function to the joint.
  5. Closure: Once the repair is completed, the incision is closed with sutures or surgical staples.
  6. Postoperative Care: After surgery, the hand is typically immobilized with a splint or cast to protect the repaired ligament as it heals. Physical therapy and rehabilitation exercises are often prescribed to gradually restore strength, flexibility, and function to the hand. The rehabilitation process may involve a gradual progression of exercises to prevent stiffness and promote optimal healing of the repaired ligament.

Recovery from hand ligament repair surgery can vary depending on the extent of the injury and your overall health. It may take several weeks to months to recover, during which time you may need to avoid certain activities. Most patients experience significant improvement in hand stability and function following surgery.

Tears in hand tendons and ligaments can result from a variety of injuries, including:

  1. Trauma: Direct trauma to the hand, such as from a fall, crush injury, or impact during sports, can cause tears in tendons and ligaments. This may occur due to sudden stretching, twisting, or forceful hand bending.

  2. Lacerations: Cuts or lacerations to the hand can damage tendons and ligaments if deep enough to reach these structures. Sharp objects or machinery accidents are common causes of hand lacerations.

  3. Repetitive Stress: Overuse or repetitive movements of the hand and wrist can lead to chronic stress and strain on tendons and ligaments, increasing the risk of tears over time. This is common in activities or occupations that involve repetitive gripping, twisting, or bending motions, such as typing, playing musical instruments, or manual labor.

  4. Sports Injuries: Participation in sports activities, particularly those that involve throwing, catching, gripping, or contact with equipment or opponents, can increase the risk of tendon and ligament injuries in the hand. Examples include baseball, basketball, football, and rock climbing.

  5. Degenerative Changes: With age, tendons and ligaments in the hand may undergo degenerative changes, becoming weaker and more susceptible to injury. Conditions such as arthritis or tendonitis can contribute to the development of tears in these structures.

  6. Rheumatoid Arthritis: Inflammatory conditions like rheumatoid arthritis can cause inflammation and weakening of tendons and ligaments in the hand, leading to tears and instability.

  7. Tendon Dislocation: Dislocation of tendons from their normal position can occur due to trauma or sudden force, leading to tears or avulsions where the tendon attaches to the bone.

  8. Fractures: Fractures of the bones in the hand can sometimes involve associated injuries to the surrounding tendons and ligaments, particularly if the fracture extends into the joint or affects the attachment sites of these structures.

These injuries can vary in severity, with some causing partial tears or strains while others result in complete tears.

Prompt evaluation and treatment by Dr. Pournaras and his medical staff are essential to prevent complications and achieve the best outcome for hand, tendon, and ligament injuries.

Recovery from hand tendon and ligament surgery can vary greatly depending on the specific procedure performed, the extent of the injury, and your health and response to surgery. Here are some general guidelines and stages you might expect during your recovery:

Immediate Postoperative Care

  • Pain Management: You will likely experience some pain after surgery, which can be managed with medications prescribed by Dr. Pournaras.
  • Splinting or Casting: Your hand may be immobilized with a splint or cast to protect the repaired tendons and ligaments.
  • Elevation: Elevating your hand above your heart can help reduce swelling and pain.
  • Early Rehabilitation
  • Physical Therapy: After a period of immobilization, physical therapy usually begins. It’s crucial for regaining strength and flexibility but will be tailored not to strain the healing tissues.
  • Gentle Range-of-Motion Exercises Initially, exercises are gentle and aim to slowly increase mobility without compromising the surgical repair.

  • Progressive Strengthening

  • Increased Exercise Intensity: As healing progresses, the intensity of exercises can increase under the guidance of our physical therapist.

  • Gradual Return to Activities: You’ll gradually be allowed to resume more strenuous activities as strength and flexibility improve.
  • Long-Term Recovery and Rehabilitation
  • Continued Physical Therapy: Therapy may continue for several months depending on the surgery’s complexity and the desired level of function.
  • Follow-Up Care: Regular check-ups with Dr. Pournaras or our hand-hand therapist, who will monitor your recovery and address any complications.

 

Factors Influencing Recovery

  • Type of Surgery: Different procedures have different recovery timelines and challenges.
  • Patient Compliance: Following Dr. Pournaras and our physical therapist’s instructions closely can increase your recovery speed and give you the best outcome.
  • Overall Health: Pre-existing conditions, such as diabetes or rheumatoid arthritis, can affect healing times.

 

Tips for a Smooth Recovery

  • Adhere to Post-Op Instructions: Follow all post-operative care instructions provided by Dr. Pournaras.
  • Stay Active Within Limits: Engage in approved activities to promote circulation and healing, but don’t overdo it.
  • Healthy Lifestyle: A healthy diet, adequate rest, and avoiding smoking can facilitate a quicker recovery.

When to Seek Help

  • Signs of Infection: Fever, increased redness, or discharge from the incision site.
  • Severe Pain: Unmanageable pain or pain that significantly worsens can indicate complications.
  • Lack of Progress: If you’re not seeing improvement over time, discuss this with Dr. Pournaras.

Recovery times can vary widely; some patients may recover in a few weeks, while others may take several months. Maintaining realistic expectations and communicating regularly with Dr. Pournaras and our medical staff is essential.

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Fair Oaks Orthopedics – Fairfax,VA

Suffering from pain can limit your daily activities and decreases your enjoyment of life.  Our commitment to support your journey towards recovery can help ease your mind. Learn more about our comprehensive range of advanced treatment options for hand, wrist, elbow, and shoulder designed to provide pain relief and heal as quickly, and as safely as possible.
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Fair Oaks Orthopedics

For over 30 years, Virginia Board Certified Physician, Dr. Stephen W. Pournaras, Jr. has provided excellent healthcare and treatment for his patients. As a multi-specialty orthopedic practice, offering the best for you medically to treat, heal and lead you to optimum recovery. We are dedicated to using state-of-the-art technology while building nurturing relationships with each of our patients.

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