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Finger flexor tendon injury: causes, symptoms, diagnosis, treatment
Last reviewed: 04.07.2025
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ICD-10 code
- S63.4 Traumatic rupture of ligament of finger at level of metacarpophalangeal and interphalangeal joint(s).
- S63.6. Sprain and injury of the capsular-ligamentous apparatus at the level of the finger.
What causes finger flexor tendon injuries?
Closed injuries to the flexor tendons of the fingers occur when lifting heavy flat objects (sheets of metal, glass), while open injuries occur with various wounds to the palmar surface of the hand.
Symptoms of finger flexor tendon injury
Pain at the moment of injury and subsequent loss of flexion function of the fingers are typical, only flexion in the metacarpophalangeal joints is preserved. These movements sometimes lead to diagnostic errors. To ensure the integrity of the tendons, it is necessary to ask the patient to bend the terminal phalanx with the middle one fixed, and then bend the middle one with the main one fixed. Such movements are possible only with intact tendons. Open tendon injuries are diagnosed based on the impairment of finger function, as well as the distal ends of the tendons visible in the wound. The proximal ends of the tendons are displaced towards the forearm due to muscle contraction.
[ Treatment of damage to the flexor tendons of the fingers
Surgical treatment
Treatment of damage to the flexor tendons of the fingers of the hand is only surgical. In the early stages, a primary suture of the tendon is made using one of the methods; in case of old damage, tendon plastic surgery is resorted to using autogenous tissues or various transplants.
The primary tendon suture is the most favorable, but it, like the secondary one, has a number of features and presents considerable technical difficulties. The suture material for joining the ends of a torn or cut tendon must be as thin as possible and at the same time very strong. This can be steel or chrome-nickel wire, capron, nylon and other synthetic materials. By the way, they are preferable, since they are inert, unlike metal, silk and (especially) catgut.
Another technical difficulty is the special structure of the tendon, the fibers of which easily delaminate, as a result of which the suture becomes insolvent. If the suture captures layers more than a third of its diameter, the blood supply to the tendon is disrupted. In addition, rough manipulations with the tendon and its sheath cause the development of an adhesion process, which negates the functional results of the operation.
A revolutionary breakthrough in tendon surgery was the proposal by Bennell (1940) to use removable blocking sutures and their subsequent modifications (Bennell II suture, 1940; Degtyarev S.I. suture, 1959; Pugacheva A.G. suture, 1960). Unloading the injury site, a minimum number of sutures and suture material, removal of suture material, and preservation of tendon blood circulation dramatically improved the results of treating finger flexor injuries.