How difficult is it to treat a hand tendon injury? This is a transcript of a Dr. Jay Show broadcast on 1560TheGame. Dr. J. Michael Bennett is a Board Certified Orthopedic Surgeon and a Fellowship Trained Sports Medicine Physician serving patients from Katy, Fort Bend County, Metro Houston and Southeast Texas from offices in Houston, near the Galleria and Sugar Land, TX. Call 281-633-8600 for an appointment. Our special guest on this Show is Dr. Alan Rodgers, who is a hand specialist practicing in the Katy area.
Here’s the summary of the seventh portion of this Show:
Dr. J. Michael Bennett Dr. Rodgers mentioned infections and that’s a big deal, and I think that hand tendon injury is a big deal, and, like anything else, you’ve got to know when to go see the doc, and, believe it or not, we’re not going to all throw you into the operating room and operate on you as soon as we see you. About 80 to 90 percent of the patients I see do not require surgery; a lot of these issues we’re talking about today can be treated non-operatively, but some of them that do need surgery need it done relatively soon because you can avoid irreversible damage whether it’s nerve issues, whether it’s tendon issues or whatever. You do not want to ignore these things. You want to be seen and evaluated. We were just talking about hand tendon injuries and tendon ruptures and Dr. Rodgers, what kind of procedures are you looking at regarding someone who is like cutting tomatoes and they slice their tendon? Are you more likely to see nerve vessel injuries and can you repair those injuries, what is the recovery on a tendon repair, and how do you repair a tendon?
Dr. Alan Rodgers: As far as hand tendon repairs, prognosis on those is very location dependent. Where you cut the tendon is so important and oftentimes it’s cut in one of the worst places possible which is from the location where your palm ends to the last crease on the palm side of your finger. We call that Zone 2 as surgeons. It’s really a tight spot that is very difficult to recover from hand tendon injuries because you have two tendons and a very narrow space. It’s much easier to recover from tendon injuries if they’re done in the palm or even at the very tip of the finger. Say someone is slicing tomatoes or working in the kitchen and does stab a tendon; most of the time if it’s located on the finger it’s going to be related to at least a partial nerve or partial blood vessel injury. It’s very hard, as you can imagine, when you are using a large knife as most kitchen knives are, to just hit a tendon and that’s it. So usually the damage is a little more extensive. If you cut yourself and you have extensive bleeding you can be assured that you probably hit the artery. It doesn’t mean your finger is going to have to be removed or anything like that, what it means is you do have two arteries on the finger and fortunately, very rarely, do I see people who hit both of those. But usually it is at least one and a nerve as well. The good news is as long as the bleeding is controlled and the finger has good blood flow from the other artery that is still intact it is not something where you have to be rushed off to the operating room and have surgery immediately. You have a window of about a week in which you need to fix tendon repairs before they start adhering or sticking down to things around them and shortening to where they can’t go out to the full length. Of course, if you cut yourself and especially if it’s bleeding, you need to go to the emergency room. But that doesn’t mean you need to have surgery immediately. What the ER physician will assess is if the finger is alive and well, he’ll inform the hand surgeon that you have a tendon injury and that’s something the hand surgeon will make accommodations to see in the office A.S.A.P., get your surgery done that week, and reconstruct that tendon.
Dr. J. Michael Bennett: It’s amazing how these days, as far as the reconstructive options are concerned regarding a hand tendon and nerve injury, a lot of that is micro-vascular and you can actually repair the nerve using a microscope or what we call loop-magnification glasses. But you want to make sure that you see a hand specialist that does these. You do not want the regular guy that does not have any experience doing this sewing up your hands because this type of procedure is a complicated procedure and the last thing you want to do is get stuck with a hand that is not working very well, especially if it is your dominant hand.
Our office is part of the highly-regarded Fondren Orthopedic Group and we refer complex wrist and hand injuries to hand specialists at Fondren for treatment. The Fondren hand surgeons are board certified and have added qualifications in hand surgery.
Dr. J. Michael Bennett treats certain wrist and hand injuries including carpal tunnel syndrome, distal radius fractures (broken wrist), trigger finger and metacarpal fractures of the hand. He specializes in using the endoscopic approach to carpal tunnel syndrome, when appropriate for the patient, which means that the carpal tunnel surgery consists of two small incisions instead of a longer incision across the middle of the palm of the hand.
If you injure your hand and would like Dr. Bennett to check it, please call our office at 281-633-8600.
