Wrist and Hand Tendon Injuries

Tendon injuries in the wrist and hand involve damage to the fibrous connective tissues that attach muscles to bones, enabling these body parts to move. These injuries can result from acute trauma or repetitive strain, affecting the tendons’ ability to move the fingers, thumb, and wrist. 

Due to the complex anatomy of the wrist and hand, these injuries require accurate diagnosis and appropriate treatment to restore function and prevent further complications.

Identifying the causes of wrist and hand tendon injuries is crucial for prevention and tailored treatment strategies.

• Repetitive Motion
  Frequent and repetitive use of the wrist and hand, especially in certain occupations or sports, can lead to tendon injuries due to overuse and strain.
• Acute Trauma
  Sudden injuries, such as cuts, impacts, or fractures, can directly damage the tendons in the wrist and hand.
• Rheumatoid Arthritis
  This autoimmune disease can cause inflammation of the tendons, particularly affecting the extensor tendons, and lead to deformities and functional impairments.
• Improper Ergonomics
  Using tools, keyboards, or equipment that do not fit the user’s hand properly or force awkward wrist positions can increase the risk of tendon injuries.
• Age
  The risk of tendon injuries increases with age as tendons lose their elasticity and ability to withstand stress.
• Underlying Health Conditions
  Conditions like diabetes and rheumatic diseases can predispose people to tendon injuries due to their impact on the body’s connective tissues.

Recognising the symptoms of tendon injuries is the first step towards seeking timely and effective medical intervention.

• Pain
  A primary symptom that may worsen when moving the affected wrist or hand, or when pressure is applied.
• Swelling
  Inflammation around the injured tendon can cause visible swelling in the wrist or hand.
• Stiffness
  Difficulty in moving the affected fingers or wrist, especially after periods of rest or inactivity.
• Weakness
  A reduction in grip strength or difficulty in performing movements requiring fine motor skills.
• Audible Clicking or Popping
  Especially in cases of trigger finger, where the tendon movement is hindered.
• Tenderness
  Painful sensations when touching the area around the affected tendon.
• Visible Deformity
  In severe cases, the finger or wrist may appear deformed or be positioned abnormally due to the tendon injury.

Accurate diagnosis of tendon injuries involves a combination of clinical evaluation and imaging techniques to determine the extent and type of injury.

• Physical Examination
  The initial step involves a thorough examination of the hand and wrist, assessing pain, swelling, range of motion, and functionality.
• Patient History
  Understanding the circumstances leading to the symptoms, including occupational hazards, recent injuries, or underlying health conditions, is crucial.
• Blood Tests
  In cases where rheumatoid arthritis or other systemic conditions are suspected, blood tests may be conducted to identify inflammatory markers or autoimmune disorders.
• Tendon Function Tests
  Specific movements and tests may be performed to assess the strength and integrity of the tendons in the wrist and hand.
• Imaging Tests
  Ultrasound: This imaging modality provides real-time images of the tendons in motion, helping to identify tears or inflammation.
  Magnetic Resonance Imaging (MRI): Offers detailed images of both soft tissues and bones, useful for diagnosing complex tendon injuries.

Surgical interventions are considered when non-surgical treatments are insufficient or in cases of severe tendon damage.

Each surgical option carries its own risks and benefits, and the choice of procedure depends on the specific type and severity of the tendon injury, as well as the patient’s overall health and activity level.

• Tendon Repair
  Directly repairing the torn or damaged tendon. This procedure is typically performed soon after the injury, especially if the tendon has been cut.
• Tenosynovectomy
  Removal of the inflamed sheath surrounding a tendon. It is often used for patients with conditions like stenosing tenosynovitis (trigger finger) or De Quervain’s tenosynovitis.
• Tendon Release
  In cases like the trigger finger, minor surgery is performed to cut open the constricted section of the tendon sheath to allow smoother tendon movement.
• Tendon Transfer
  For more severe injuries, a damaged tendon might be replaced with a tendon from another part of the body to restore function.
• Synovectomy
  Specifically for patients with rheumatoid arthritis, this involves removing inflamed synovial tissue surrounding a joint to reduce pain and swelling.
• Reconstruction
  In cases of complex or long-standing injuries, reconstructive surgery might be needed to repair and rebuild the tendons and surrounding structures.
• Joint Fusion or Arthroplasty
  For severe arthritis or deformities, fusing the joint to prevent movement or replacing it with an artificial joint may be considered.