Can Surgery Fix a Year-Old Tendon Injury in My Finger?

Old injury not healed?

I have an old injury on the first segment of my index finger, where a tendon rupture occurred over a year ago, resulting in a mallet finger.
Would surgery be beneficial? After surgery, will I be able to straighten it, or will it remain bent?

RYO, 20~29 year old female. Ask Date: 2004/12/10

Dr. Chen Weiming reply Orthopedics

Sorry for the delay.
Your email response indicates that surgery can improve the condition, but recovery will take some time.

Reply Date: 2004/12/10

More Info

When it comes to a year-old tendon injury in your finger, particularly one that has resulted in a mallet finger (or "hammer finger"), the potential for surgical intervention to restore function largely depends on the specifics of your injury and the condition of the tendon at the time of surgery.

Mallet finger occurs when the extensor tendon that straightens the finger is ruptured or avulsed, typically due to trauma. If the injury has been present for over a year, the tendon may have undergone significant changes, including scarring and retraction, which can complicate surgical repair. In general, the sooner a tendon injury is treated, the better the outcome. Delayed treatment can lead to complications such as stiffness, loss of motion, and chronic pain.

Surgery can be beneficial in cases where the tendon is still amenable to repair. The surgical procedure typically involves reattaching the tendon to the bone or repairing the tendon if it has retracted. However, the success of the surgery in restoring full function—meaning the ability to bend and straighten the finger normally—depends on several factors:
1. Condition of the Tendon: If the tendon has retracted significantly or has formed scar tissue, it may be more challenging to achieve a full range of motion post-surgery. The surgeon will assess the tendon during the procedure to determine the best course of action.

2. Surgical Technique: The method used to repair the tendon can influence the outcome. Techniques may vary from simple suturing to more complex reconstructions, depending on the nature of the injury.

3. Rehabilitation: Post-operative rehabilitation is crucial for regaining function. After surgery, a structured rehabilitation program that includes physical therapy will help improve flexibility and strength. This process can take several weeks to months, and adherence to the rehabilitation protocol is vital for achieving the best possible outcome.

4. Patient Factors: Individual factors such as age, overall health, and commitment to rehabilitation can also affect recovery. Younger patients or those in good health may have better outcomes than older patients or those with underlying health issues.

Regarding your concern about whether the finger will be able to bend after surgery, it is essential to have realistic expectations. While surgery can restore some function, it may not return the finger to its pre-injury state. Some patients experience limitations in motion or strength even after successful surgical intervention.
In summary, while surgery can potentially fix a year-old tendon injury, the outcome will depend on various factors, including the condition of the tendon, the surgical technique employed, and the rehabilitation process. It is crucial to consult with a hand surgeon who specializes in tendon injuries to evaluate your specific case and discuss the potential risks and benefits of surgery. They will provide you with a tailored treatment plan and help set realistic expectations for your recovery.

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