Hand tendon injuries can pose significant challenges, often necessitating surgical intervention to restore function and mobility. While tendon repair surgery is a critical step toward recovery, there is a risk of post-operative complications. Despite surgeons’ best efforts, rare cases may require reoperation to restore tendon functionality. Understanding common reoperation reasons can help in prevention efforts.
Rupture: Despite advancements in surgical techniques, there is always a risk of the repaired tendon rupturing again. This can be attributed to various factors, such as injury location, repair complexity, and individual healing responses. Following post-operative care guidelines, including hand immobilization and prescribed rehabilitation exercises, will assist in minimizing re-rupture and avoiding reoperation.
Adhesion Formation: Scar tissue can form between the repaired tendons and surrounding structures during the healing process. These adhesions can restrict the smooth gliding motion of the tendon, leading to stiffness and decreased range of motion (Wong, 2009). Physical therapy plays a crucial role in preventing and managing adhesions by promoting controlled movement and preventing excessive scar tissue formation. Regular follow-ups are important when monitoring for early signs of adhesion formation.
Limited Range of Motion: Limited range of motion is a common post-operative complication in hand tendon repair. Patients may experience stiffness and difficulty moving the affected fingers, especially in the initial states of recovery. Rehabilitation exercises, guided by a therapist, is a great resource for restoring flexibility and strength. Patience and consistent effort are key for regaining normal range of motion over time.
Infection: Despite preventive measures, infection can occur and potentially require reoperation. Keeping the wound clean before, during, and after surgery is essential. In many cases, antibiotics can treat infections and the healing can continue. In the instance that the antibiotics do not help,and the infection is more severe, reoperation may be needed (Goodman, 2018).
While hand tendon repair surgery is a pivotal step in restoring function and mobility, it is good to acknowledge and address potential post-operative complications. To receive the best outcomes, patients should actively engage in their recovery by adhering to recommended post-operative care, attending regular follow-up appointments, and communicating any concerns to their healthcare team. By understanding and managing their condition, individuals can improve their chances of successful recovery and regain optimal hand function.
Resources:
Goodman, A. D., Gil, J. A., Starr, A. M., Akelman, E., & Weiss, A. P. C. (2018). Thirty-day reoperation and/or admission after elective hand surgery in adults: a 10-year review. The Journal of hand surgery, 43(4), 383-e1.- https://www.jhandsurg.org/article/S0363-5023(16)31211-4/fulltext
Wong, J. K., Lui, Y. H., Kapacee, Z., Kadler, K. E., Ferguson, M. W., & McGrouther, D. A. (2009). The cellular biology of flexor tendon adhesion formation: an old problem in a new paradigm. The American journal of pathology, 175(5), 1938-1951.- https://www.sciencedirect.com/science/article/pii/S0002944010607043?ref=pdf_download&fr=RR-2&rr=86a18b7f6cd4d021