Hand tendon injury

　　This disease is mainly caused by traumatic factors, and the injury is mostly open, which can be caused by glass, knife, machinery, direct violence, etc. In war, it can be caused by explosive substances and flammable substances, among which cutting injuries are more common. It often occurs with finger nerve injury or fracture. Hand injuries can also be accompanied by varying degrees of closed fractures, dislocations, surface trauma, piercing injuries, cutting injuries, lacerations, and crush injuries.

　　Hand tendon injury is a common injury, and improper treatment often leads to complications such as edema, tendon adhesion, and tendon rupture, resulting in serious functional impairment of the fingers. Tendons belong to soft tissue, and their regeneration ability is weak after rupture. Tendon adhesion makes it difficult for them to heal on their own. Relying solely on rest or using some blood circulation and blood stasis drugs is difficult to achieve the goal of cure.

　　After the tendons are ruptured, the corresponding joints lose their functional activity, such as the rupture of the deep flexor tendon of the finger, which is manifested by the inability to flex the distal interphalangeal joint; if both the deep and superficial flexor tendons are ruptured, the interphalangeal joints on both sides of the finger cannot be flexed.

　　Different sites of extensor tendon rupture cannot extend the corresponding joints, and deformities may occur. Sometimes, tendons are not completely ruptured, and although the joint can still move, resistance tests may show weakness and pain.

　　The prevention of this disease mainly involves correctly guiding postoperative functional exercises:

　　1. Early non-resistance functional exercises:In the first 1 to 3 weeks after surgery, restrictive passive movement of the affected limb (finger) is performed to promote the longitudinal arrangement of newly formed collagen fibers, reduce adhesions, and promote healing. During this period, passive flexion and extension activities of the affected limb (finger) are performed under the strict guidance of medical personnel, with the same methods as mentioned above.

　　2. Mid-term non-resistance functional exercises:In the 4 to 5 weeks after surgery, guide the patient to perform mild active movement of the affected limb (finger), with gentle movements and moderate force, 10 times a day, each for 5 minutes, aiming for mild soreness and swelling, avoiding violent movements. Massage the muscles and joints, and use local physical therapy, such as ultrashort wave, spectrum therapy, and other therapies.

　　3. Gradually increase the resistance of functional exercises in the later stage:After 6 to 10 weeks, change from passive to active movement of the affected limb (finger) 20 times, repeat 1 to 2 times every 1 to 2 hours, master the essentials of the movements, and gradually increase the complexity of functional activities. Encourage patients to perform daily activities. After 4 to 8 weeks, completely remove the plaster protection and start weight-bearing exercises, gradually increasing resistance activities; after 10 weeks, according to the patient's job nature or wishes, various types of occupational training should be carried out to prepare for reintegration into society and the resumption of work.

　　Physical examinations of patients with this disease can reveal different sites of extensor tendon rupture. Tendons are fibrous or membranous dense connective tissues at the ends of the muscle belly, which are convenient for muscle attachment and fixation. The tendons of a muscle are attached to two or more different bones, which is due to the traction effect of the tendons, enabling the contraction of the muscle to drive the movement of different bones. Each skeletal muscle is divided into the muscle belly and the tendon, and the corresponding joint cannot be extended, and deformities may occur. Sometimes, tendons are not completely ruptured, and although the joint can still move, resistance tests may show weakness and pain.

　　1. Foods that are good for the body for hand tendon injuries

　　Nutritious and easily digestible foods.

　　2. Foods to avoid for hand tendon injuries

　　Avoid eating spicy foods.

　　(The above information is for reference only, for details please consult a doctor)

　　The early treatment of this disease mainly includes the following aspects:

　　1. Thorough examination:To formulate the best surgical plan, careful preoperative and intraoperative examinations are essential, as they are related to the success and outcome of the surgery. This includes confirming the time between the injury and the surgery, the area of the tendon rupture, the number of ruptures, the degree of wound contamination, and the extent of tissue damage around any unstable fractures. Only then can it be determined whether early treatment of the tendons is necessary and what the treatment methods should be. For wounds within 12 hours, with less contamination, cleaner incisions, and smaller tendon defects, early suture and primary closure of the wound should be strived for. The normal structure and stability of the skeleton, as well as the coverage of the wound surface, are prerequisite conditions for early tendon repair.

　　2. Debridement:Early and thorough debridement is a key factor directly affecting the prognosis. Its purpose is to remove necrotic tissue contamination and foreign bodies, turn contaminated wounds into clean wounds, and also help further understand the injury situation of tendons and peritendinous tissue, facilitating the next step of treatment. Debridement can reduce post-traumatic inflammatory reactions, avoid the accumulation of large amounts of serum fluid in the wound, causing severe tendon adhesion after surgery.

　　3. Tendon Repair:The principle of repair is tension-free, twist-free, and damage-free. Postoperative tendon adhesion and re-tear are the main complications, and tendon adhesion is currently a难题 that has not been completely solved. To prevent tendon adhesion during repair, we need to explore from three aspects:

　　1. Selection of suture methods and suture materials.

　　2. Protection of peritendinous tissue.

　　3. Application of materials for preventing adhesion.

　　There are many methods of tendon suture, and the advantages of Kessler's method lie in its strong and reliable suture, which is not easy to split at the suture site, and is conducive to early activity; the rough surface of the anastomosis is less, which can reduce the chance of tendon adhesion. Moreover, Kessler's method has less impact on the blood supply relationship of the tendons. Choosing appropriate suture materials can further make up for the shortcomings of the surgical method. Peritendinous tissue refers to the tendons' inner and outer membranes, sheaths, and tendinous loops, and should be avoided during tendon repair. Peritendinous tissue is the provider of the tendons' blood supply, which can maintain the integrity of the tendons' sliding structure and reduce postoperative tendon adhesion.

　　4. Postoperative Management:The activity after tendon repair is crucial. Early activity on the basis of strong suture can effectively reduce adhesion, and even with mild adhesion, appropriate exercise can gradually soften and elongate the adhesion tissue, restoring a certain degree of sliding function to the repaired tendons. The dressing should be limited to the wound surface, and it is as exposed as possible to facilitate early functional exercise; appropriate pressure can limit inflammatory reaction exudation and swelling, bleeding, and can help the healing of tendons. The pressure should not cause nerve compression symptoms.