Tendon, nerve and vascular injuries are frequently seen injuries in hand incisions, which we encounter frequently in hand surgery practice. If there is damage to one of these structures, surgical treatment will probably be required. In order to understand whether there is an injury that requires surgery, an examination by a relevant branch physician is absolutely necessary.
Tendons (beams) are the last parts of the muscles and are responsible for moving them by passing through the joints and attaching to the bones. The tendons that make the fingers bend are the flexor tendons, and the ones that make the opening movement are the extensor tendons. If there is difficulty in these bending or opening movements of the fingers, tendon damage has probably occurred. Surgical repair is required in almost all tendon injuries caused by incision. The sooner the surgery, the better, but it is generally recommended to be performed within the first 7-10 days. Tendon incisions that are delayed for more than three weeks often cannot be repaired end-to-end, and additional procedures may be required. In addition, even if the surgery is performed on the first day, the skin incisions are widened for the repair process, since the tendon is a movable structure, due to retraction. In other words, a larger surgical incision than the existing incision should be expected after these operations.
Nerves have two tasks (sensory and motor nerves) to provide sensation and to operate muscles. The most typical finding is numbness and tingling-like numbness at the site of the cut nerve. Depending on the type of nerve cut, some muscle loss of function can also be seen. Nerve repairs are performed with microsurgical techniques. The recommended repair time is the first 3 days.
Veins are structures that bring blood to the limbs. If cut, active bleeding may occur. Generally, hand or finger nutrition is provided by more than one vein. Therefore, every vascular incision may not impair the nutrition of the limb, but it should be kept in mind that if there are color changes such as whitening or bruising on the skin, there may be a circulation problem. Vascular repairs are more urgent than tendon and nerve repairs. A hand or finger with circulation problems should be treated as early as possible. Veins, like nerves, are repaired with microsurgical technique.
The recovery period after tendon, nerve and vessel cuts is important. At least as much as the surgery performed, the post-operative physical therapy and rehabilitation process also affects the functions. After the surgery, plaster/splint is applied for varying periods of time, depending on the type of injury. Unfortunately, it is not possible to return to work directly after the surgery. Physiotherapy is applied during and after splinting. After nerve repair, nerve tissue is regenerated from the repair line. Although this regeneration rate varies from person to person, it is around one millimeter per day on average. Considering the level of the incision, recovery should not be expected in the early period. Unfortunately, if there is a high level of injury in nerve cuts, the recovery period is long.