Hand Tendon Repair: questions and answers
Hand tendon repair is a surgery to fix torn tendons so your fingers and thumb can move properly again. Our team at Jaipur Hospital will guide you through each step of the process.
Understanding hand tendon repair
This section explains what hand tendons do, how they get injured, and why surgery may be needed.
What does hand tendon repair involve?
In short
Hand tendon repair at Jaipur Hospital involves microsurgical stitching of a cut or ruptured tendon in the hand. The operation usually takes one to two hours under regional or general anaesthesia. You may go home the same day or stay one night. Protected motion begins after surgery and continues for about six weeks, with full strength returning around three months.
In detail
The surgeon makes a small incision to find the divided tendon ends and sutures them together using strong core stitches and a finer outer suture.
Techniques include primary repair within 24 hours, delayed primary repair up to two weeks, or a two-stage tendon graft for chronic loss. Evidence shows that adding an epitendinous suture reduces re-operation rates and modified Kessler technique lowers adhesion formation.
Early controlled motion protocols such as Duran passive mobilisation are started soon after surgery to glide the tendon and limit stiffness.
A common belief
Many people think the tendon heals on its own or that you can move the hand freely right after surgery.
What actually happens
In reality, the repair is delicate and needs a strict splint and passive exercise programme for six weeks to prevent the stitches from pulling apart or the tendon sticking down.
Your next step at Jaipur Hospital
After the operation your hand will be placed in a dorsal splint with the wrist and fingers positioned to protect the repair. A hand therapist will teach you passive exercises every two hours for the first four weeks. Splint wear is gradually reduced over eight weeks. Strengthening begins after week eight. Full recovery takes about three months.
Why might my doctor recommend hand tendon repair?
In short
A doctor at Jaipur Hospital may recommend hand tendon repair when a tendon is completely cut or ruptured so that you cannot bend or straighten one or more finger joints. Without surgical repair the tendon ends will not rejoin on their own and the finger will remain stuck in a straight position, causing long-term loss of hand function.
In detail
Tendons are the cords that connect forearm muscles to finger bones. When a deep cut or sudden force snaps a tendon, the muscle pulls the cut end away and the gap fills with scar tissue.
Evidence shows that early repair within two weeks gives the most suitable chance of restoring glide and strength. Delayed or chronic injuries may need a tendon graft or later tenolysis to release adhesions. The goal is to return active motion so you can grip, pinch and use the hand for daily tasks.
A common belief
Some patients hope that rest or physiotherapy alone will fix a cut tendon.
What actually happens
That is not possible because the muscle pulls the cut ends apart. Only microsurgical stitching can bridge the gap, and the sooner it is done the better the result.
Your next step at Jaipur Hospital
Your surgeon will examine the finger for loss of active flexion or extension, check the wound, and may order an ultrasound to confirm the tendon gap. If repair is advised, surgery is scheduled promptly. After the operation you will follow a protected motion programme for six weeks and strengthening for three months.
How will the doctor decide whether I need hand tendon repair?
In short
At Jaipur Hospital the surgeon decides on hand tendon repair by examining your hand for loss of active finger movement, checking the wound for a tendon gap, and assessing sensation and blood flow. If you cannot bend or straighten a joint against resistance, the tendon is likely divided and repair is usually advised.
In detail
The clinical test asks you to actively flex and extend each finger joint while the surgeon watches. A cut flexor tendon means you cannot bend the fingertip or middle joint; a cut extensor tendon means you cannot straighten the joint.
The surgeon also looks for the resting posture of the finger — a straight finger that should be curved suggests flexor loss. Ultrasound may be used to confirm the gap or rule out a partial tear.
Evidence shows that early diagnosis and repair within two weeks gives better outcomes. If the injury is old or the tendon ends are retracted, a two-stage graft may be planned instead.
A common belief
Patients sometimes think an X-ray or MRI is always needed first.
What actually happens
In most clean-cut injuries the clinical examination is enough. Scans are only used when the diagnosis is unclear or to check for a partial tear or foreign body.
Your next step at Jaipur Hospital
Bring any previous X-rays or scan reports to the appointment. The surgeon will explain the findings and the recommended timing of surgery. If repair is needed, you will be scheduled for the operation and given pre-operative instructions.
Preparing for hand tendon repair
Learn what tests you may need and how to get ready at home before your operation.
Which tests and scans do I need before hand tendon repair?
In short
Before hand tendon repair at Jaipur Hospital most patients need only a clinical examination. Routine blood tests such as haemoglobin, blood sugar, and infection markers are done for anaesthesia safety. An X-ray may be ordered if a fracture is suspected. Ultrasound is sometimes used to confirm a tendon gap or partial tear when the examination is unclear.
In detail
The surgeon's primary tool is the bedside test of active finger motion. Evidence shows that in clean lacerations the clinical diagnosis is reliable. Blood work ensures you are fit for regional or general anaesthesia.
If the injury involved crushing, glass, or a fall, an X-ray checks for bone fragments or a foreign body. Ultrasound can visualise the tendon ends and measure the gap, which helps plan a primary repair versus a graft. MRI is rarely needed and only for complex cases with suspected deep infection or nerve involvement.
A common belief
People often expect an MRI or CT scan for every hand injury.
What actually happens
In reality, those are rarely needed. The surgeon's hands-on test of finger movement is the most accurate way to decide if the tendon is cut and whether it can be repaired directly.
Your next step at Jaipur Hospital
On the day of your pre-operative visit the nurse will draw blood and the radiology department will perform any X-ray or ultrasound the surgeon has requested. Results are usually available the same day. If all tests are normal, surgery can be scheduled within a few days.
How should I prepare in the days before hand tendon repair?
In short
In the days before hand tendon repair at Jaipur Hospital, keep the hand clean and protect the injured finger from further trauma. Stop smoking if you can, as it impairs tendon healing. Arrange for an attendant to stay with you on the day of surgery and help at home afterwards. Follow any specific medication advice given by your surgeon.
In detail
Good skin condition reduces infection risk. Avoid cuts, burns or insect bites on the operative hand. If you take blood thinners, diabetes medicines or herbal supplements, the surgeon will tell you which to pause and when. Eat a balanced diet and stay hydrated.
Prepare loose clothing with wide sleeves that fit over a bulky dressing. Have ice packs and pillows ready at home for elevation. The physiotherapy team may give you a pre-operative appointment to teach splint care and the first exercises. Evidence shows that patients who understand the rehabilitation protocol before surgery cope better with the splint and exercise routine.
A common belief
Many people ignore the smoking advice.
What actually happens
Smoking reduces blood flow to the healing tendon and increases the risk of rupture. Even cutting down helps.
Your next step at Jaipur Hospital
Confirm your admission time with the hospital. Bring your test reports, insurance cards and a list of current medicines. Do not wear jewellery or nail polish on the operative hand.
Do I need to fast before hand tendon repair, and when should I stop eating and drinking?
In short
Yes, you must fast before hand tendon repair because regional or general anaesthesia requires an empty stomach. Stop solid food six hours before the scheduled operation time. You may drink clear water up to two hours before. The hospital will confirm the exact fasting start time when your surgery slot is fixed.
In detail
Fasting prevents aspiration of stomach contents during anaesthesia. The six-hour rule for solids and two-hour rule for clear fluids follows standard anaesthesia safety guidelines. If your surgery is in the morning, you typically stop eating at midnight and may sip water until 6 am.
If you take regular morning medicines such as for blood pressure, the anaesthetist will advise which to take with a sip of water. Diabetic patients get specific instructions about insulin or oral hypoglycaemic dosing on the day of surgery. Do not chew gum, suck sweets or drink milk, juice or tea during the fasting window.
A common belief
Some patients think tea or coffee with milk counts as clear fluid.
What actually happens
It does not. Milk delays stomach emptying. Only plain water is allowed in the last two hours.
Your next step at Jaipur Hospital
You will receive a call or message with your reporting time and fasting instructions the day before surgery. Bring a light snack for after the procedure if you are a daycare patient.
Which medicines, supplements, or herbal products should I discuss with the doctor before hand tendon repair?
In short
Before hand tendon repair at Jaipur Hospital, tell your surgeon about every medicine you take. This includes blood thinners such as aspirin, clopidogrel or warfarin, diabetes tablets or insulin, blood pressure medicines, steroids, and any herbal or ayurvedic products. Some supplements like ginkgo, garlic, ginger or vitamin E can increase bleeding risk.
In detail
The surgeon and anaesthetist review your list to decide which medicines to continue, pause or adjust. Blood thinners are usually stopped several days before surgery depending on the drug and your cardiac risk. Diabetes medicines may need dose changes on the fasting day.
Steroids may require a stress dose. Herbal products are often stopped one to two weeks prior because their effect on clotting and anaesthesia interaction is unpredictable. Bring the actual bottles or a written list with doses to your pre-operative visit. Do not stop any prescribed medicine on your own without medical advice.
A common belief
Patients often forget herbal supplements or think they are harmless.
What actually happens
Ginkgo, garlic, ginger and high-dose vitamin E can thin the blood. The anaesthetist needs to know everything you take.
Your next step at Jaipur Hospital
You will receive a written medication plan at the pre-anaesthesia check-up. Follow it exactly. If you start any new medicine or supplement after that visit, inform the hospital immediately.
Risks and results of hand tendon repair
Read about the possible complications and what outcomes you can generally expect.
What are the common side effects and the less common serious complications of hand tendon repair?
In short
After hand tendon repair at Jaipur Hospital, common side effects include swelling, stiffness, and discomfort around the wound and fingers. You will wear a splint that limits movement for several weeks. These effects are expected and usually improve with guided therapy.
In detail
Evidence shows that adhesion formation, where the repaired tendon sticks to surrounding tissue, remains a common complication even with careful repair. In studies, the incidence of adhesions after flexor tendon repair was about 4%, and the rupture rate was also around 4%.
Re-operation occurred in roughly 6% of cases. Using an epitendinous suture lowers re-operation risk by 84%, and the modified Kessler technique reduces adhesion development by 57%. Early passive motion protocols carry a lower rupture risk than early active motion but may lead to more stiffness. Infection and nerve injury are less common but possible serious complications.
- Re-operation occurred in roughly 6% of cases.
A common belief
Many people think the repair itself is the main risk, but adhesions and stiffness are more frequent.
What actually happens
Studies show adhesion rates around 4% and rupture rates around 4%. Re-operation happens in about 6% of cases. Good surgical technique and the right motion protocol lower these risks.
Your next step at Jaipur Hospital
Your surgical team will explain the specific signs to watch for, such as sudden loss of finger movement, increasing pain, redness spreading from the wound, or fever. Attend all follow-up appointments so healing can be checked. Hand therapy usually starts within days and continues for months.
What factors could make hand tendon repair riskier for me?
In short
Several factors can increase the risk of complications after hand tendon repair at Jaipur Hospital. These include the zone of injury, especially zone II where tendons pass through a tight sheath, the time between injury and repair, the presence of associated fractures or nerve injuries, and patient factors such as smoking, diabetes, or poor compliance with splinting and therapy.
In detail
Evidence indicates that early injuries repaired promptly tend to have better outcomes than late presentations. The study data showed early ruptures had a higher overall complication rate than late injuries, but delayed repair in scarred tissue is also challenging.
Associated fractures and nerve injuries were exclusion criteria in some outcome studies because they worsen prognosis. Smoking impairs wound and tendon healing. Diabetes can delay recovery and increase infection risk.
The type of rehabilitation protocol matters: early passive motion has a statistically lower rupture risk than early active motion but a higher risk of postoperative stiffness. Your surgeon will assess all these factors before planning surgery.
A common belief
People often think only the surgery matters, but when you have surgery and how you follow rehabilitation are just as important.
What actually happens
Studies show early passive motion has lower rupture risk than early active motion but more stiffness. Smoking and diabetes slow healing. Your surgeon weighs all these before operating.
Your next step at Jaipur Hospital
At your consultation, the surgeon will examine your hand, review any imaging, and discuss your medical history. They will explain how these factors apply to you and what can be done to minimise risk, such as optimising blood sugar control or stopping smoking before surgery.
Recovery and follow-up after hand tendon repair
Find out what happens after surgery, including therapy, splint use, and follow-up visits.
How long does recovery usually take after hand tendon repair?
In short
Recovery after hand tendon repair at Jaipur Hospital is a staged process. Protected motion in a splint typically lasts six weeks. Regaining full strength and function usually takes about three months, though some stiffness may persist longer. The exact timeline depends on the tendon injured, the repair technique, and how closely you follow the therapy programme.
In detail
Evidence from structured rehabilitation programmes shows therapy starts the first day after surgery and continues for twelve weeks. The first four weeks focus on wound care, swelling control, and passive mobilisation using protocols such as Duran, with exercises every two hours.
Weeks four to eight add active assisted exercises, tendon gliding, and grip strengthening. Weeks eight to twelve progress to strengthening with balls and functional tasks.
Splinting is gradually reduced: wrist and finger positions are adjusted every two weeks until the splint is removed after week eight.
Studies assessing outcomes at six months using the Strickland classification found excellent results in 21%, good in 45%, fair in 12%, and poor in 22% of patients. Grip strength was rated good in 64% at six months.
- Grip strength was rated good in 64% at six months.
A common belief
Many expect a quick return to normal, but the tendon heals slowly.
What actually happens
Research shows therapy runs daily for twelve weeks, with splint changes every two weeks. At six months, only about two-thirds achieve good or excellent motion, and 64% have good grip strength. Rushing the process risks rupture.
Your next step at Jaipur Hospital
You will attend regular hand therapy sessions and follow a home exercise programme. The splint must be worn exactly as instructed. Do not force movements beyond what the therapist allows. Full return to heavy manual work may take longer than three months.
Which symptoms are expected after hand tendon repair, and which need urgent medical attention?
In short
After hand tendon repair at Jaipur Hospital, expected symptoms include swelling, bruising, mild to moderate pain at the wound, stiffness, and a sensation of tightness when moving the fingers within the allowed range. These improve gradually with therapy and elevation.
In detail
Evidence shows patients can expect some residual digital stiffness following flexor tendon sheath infection even with prompt treatment. The Kanavel cardinal signs help differentiate infection: uniform finger swelling, flexed posture, tenderness along the tendon sheath, and pain on passive extension.
Sudden loss of active finger movement, a snapping sensation, or inability to bend the finger may indicate tendon rupture. Increasing redness, warmth, throbbing pain, fever, or pus from the wound suggest infection. Numbness or tingling that worsens may signal nerve compression. The incidence of rupture after flexor tendon repair was 4% and re-operation 6% in reported series.
A common belief
Patients often think any pain means something is wrong.
What actually happens
Some pain and stiffness are expected during rehabilitation. The dangerous signs are mechanical — a snap or sudden inability to bend the finger — or signs of infection like fever and spreading redness.
Your next step at Jaipur Hospital
Keep the hand elevated above heart level for the first few days. Take prescribed pain medication as directed.
If you notice sudden inability to move a finger, a popping feeling, spreading redness, fever above 38°C, or worsening numbness, contact the hospital immediately or visit the 24×7 emergency department. Do not wait for the next scheduled appointment.
How should I care for any wound or dressing after hand tendon repair?
In short
After hand tendon repair at Jaipur Hospital, the wound is covered with a sterile dressing and incorporated into a custom thermoplastic splint. Keep the splint and dressing dry and intact. Do not remove or adjust the splint. The nursing team will check the wound at your first follow-up, usually within five to seven days.
In detail
Evidence from rehabilitation protocols emphasises that wound care and swelling management are the focus of the first four weeks. The splint holds the wrist in 30 to 40 degrees flexion and the finger joints in a protected position to offload the repair.
The dressing must stay clean and dry to prevent infection, which can lead to severe digital stiffness or even amputation if the tendon sheath becomes infected. Elevation above heart level reduces swelling and helps wound healing.
If the dressing becomes wet, soiled, or loose, contact the hospital for a review rather than changing it yourself.
The splint is adjusted at set intervals: at two weeks the wrist position is reduced, at four weeks further reduced, and at six weeks the wrist is neutral. The splint is removed after eight weeks.
A common belief
People want to peek at the wound or loosen the splint, but the splint protects the repair and the dressing prevents infection.
What actually happens
Studies show tendon sheath infection can cause severe stiffness or amputation. The splint position changes every two weeks as healing progresses. Only the clinical team should adjust it.
Your next step at Jaipur Hospital
Keep your hand elevated on pillows when resting. Use a waterproof cover for bathing. Do not put anything inside the splint. Attend all scheduled dressing checks. If you notice increasing pain, odour, or discharge, call the hospital.
When can I bathe or shower after hand tendon repair?
In short
After hand tendon repair at Jaipur Hospital, you may shower from day one if you keep the dressing and splint completely dry using a waterproof cover or plastic bag sealed above the elbow. Do not submerge the hand in a bath, bucket, or pool until the surgeon confirms the wound is fully healed, usually after suture removal at 10 to 14 days.
In detail
The initial dressing and splint remain in place for the first 5 to 7 days. Protocols show splinting continues full-time for 4 weeks with specific wrist and finger angles to protect the repair.
Getting the dressing wet softens the wound edges, increases infection risk, and can loosen the splint. A waterproof cast cover or a heavy-duty plastic bag taped securely above the elbow works for showering. Keep the hand out of the direct water stream.
If the dressing becomes damp, do not remove it; contact the hospital for a dressing change. The wound must be dry and sealed before unprotected water exposure.
A common belief
Patients often think a quick dip or a wet dressing is harmless once the surface looks dry.
What actually happens
Moisture under the dressing breeds bacteria and weakens the healing tendon. The splint must stay dry to maintain its shape and the precise joint angles that protect the repair.
Your next step at Jaipur Hospital
Prepare a waterproof cover before surgery. Have an attendant help you bathe for the first week. After suture removal and wound healing, you may wash the hand gently with soap and water, pat it dry, and reapply the splint immediately. Avoid soaking the scar for several more weeks.
What can I eat and drink during recovery from hand tendon repair?
In short
After hand tendon repair at Jaipur Hospital, eat a balanced diet with adequate protein, vitamins, and fluids to support tissue healing. No special diet is required unless you have diabetes or other conditions. Avoid alcohol while taking pain medication or antibiotics. Stay well hydrated.
In detail
Protein provides the building blocks for tendon collagen. Vitamin C aids collagen synthesis. Zinc and iron support wound healing. If you have diabetes, strict blood sugar control is essential because high glucose impairs healing and increases infection risk.
Evidence shows patients with medical comorbidities who present late with advanced infection can expect poorer outcomes. Smoking reduces blood flow to the healing tendon; stopping smoking improves results. The hospital canteen provides dietary meals if you stay overnight. There are no food restrictions from the surgery itself, but a nutritious diet helps recovery.
A common belief
Some believe special supplements or herbs speed tendon healing.
What actually happens
Evidence supports basic nutrition — protein, vitamin C, zinc, iron — and good diabetes control. Smoking is the single most avoidable factor that slows healing. Extra supplements do not replace these fundamentals.
Your next step at Jaipur Hospital
Include dal, eggs, dairy, lean meat, or plant protein at each meal. Eat fruits and vegetables for vitamin C. Drink water regularly. If you take blood thinners or other medicines, ask your surgeon about any dietary interactions. Continue any prescribed supplements.
More questions about hand tendon repair
Browse answers to common questions patients ask about daily activities and healing.
How will tendon, nerve, or muscle damage be assessed after hand tendon repair?
In short
After hand tendon repair at Jaipur Hospital, assessment is done at set intervals by the surgical team and hand therapists. They check active and passive range of motion, tendon gliding, grip strength, and sensation. Formal scoring systems such as the Strickland classification for total active motion and the American Society of Hand Therapists protocol for grip strength are used at six weeks, three months, and six months.
In detail
Evidence from outcome studies shows patients are evaluated at eight, ten, and twelve weeks, with final assessment at six months. The Strickland classification calculates total active motion as a percentage of normal.
Grip strength is measured with the elbow at ninety degrees, wrist in thirty degrees extension, using a dynamometer. Sensation is tested for nerve recovery using two-point discrimination and Semmes-Weinstein monofilaments. Muscle bulk and tone are observed.
In one study, Strickland results at six months were excellent in 21%, good in 45%, fair in 12%, and poor in 22%. Grip strength was good in 64%. These objective measures guide therapy progression and decide if tenolysis or further surgery is needed.
- Grip strength was good in 64%.
A common belief
Patients often go by feel, but objective scores guide decisions.
What actually happens
The Strickland classification gives a percentage of normal motion. Grip strength is tested in a set position. Nerve recovery is tracked with two-point discrimination. Studies show at six months only 21% achieve excellent motion and 64% good grip. These numbers tell us if more therapy or tenolysis is needed.
Your next step at Jaipur Hospital
You will attend regular therapy sessions where these measurements are taken. The therapist will teach you the exercises for each phase. Your surgeon reviews the scores at follow-up visits. If stiffness or weakness persists, the plan is adjusted.
Could nerve tests or imaging help with the diagnosis of a hand tendon injury?
In short
Yes, nerve tests and imaging can help diagnose a hand tendon injury at Jaipur Hospital. Your surgeon may order nerve conduction studies or electromyography if nerve damage is suspected. Ultrasound or MRI scans can show the exact site and extent of a tendon cut or rupture. These tests guide the choice of repair technique and timing.
In detail
Clinical examination remains the first step. The Kanavel cardinal signs help differentiate tendon injury from other conditions with similar presentations. If the examination suggests a nerve injury or a complex wound, nerve conduction studies assess nerve function.
Ultrasound is useful for dynamic assessment of tendon continuity and movement. MRI provides detailed soft tissue images for chronic injuries or when a graft may be needed. The results help your surgeon decide between primary repair, delayed primary repair, or a two-stage tendon graft reconstruction.
A common belief
A clinical check alone can miss a hidden nerve injury or a retracted tendon.
What actually happens
Imaging shows the exact gap and helps choose between direct suture or a graft.
Your next step at Jaipur Hospital
Your surgeon will order the appropriate tests during your outpatient consultation. Most imaging is done in-house at Jaipur Hospital and results are usually available within a day. After the tests, your surgeon will explain the findings and recommend a surgical plan. You can then schedule the operation.
Can splinting, activity changes, or therapy be tried first for a hand tendon injury?
In short
A completely cut or ruptured tendon will not heal with splinting or therapy alone at Jaipur Hospital. The tendon ends retract and cannot rejoin without surgical repair. Non-operative care is only considered for partial tears where the tendon is still largely intact, or when surgery is not possible due to severe medical illness. Your surgeon will advise after examining the injury.
In detail
Evidence shows that early surgical repair followed by a structured rehabilitation programme gives the most reliable return of motion. In studies, protected motion protocols started within days of repair achieve over 80% good or excellent outcomes in zone 2 repairs.
Splinting without repair leaves a long-term gap, resulting in loss of active flexion or extension. Therapy is essential after surgery, not as a substitute for it.
A common belief
Splinting and therapy are the core of recovery after repair, not a replacement for it.
What actually happens
Without surgery the finger will not bend or straighten actively.
Your next step at Jaipur Hospital
If you suspect a tendon injury, do not wait. Attend the OPD or emergency department for assessment. The surgeon will determine whether the tendon is partially or completely torn and discuss the appropriate timing for repair.
Does the timing of treatment affect recovery of strength or sensation for a hand tendon injury?
In short
Yes, timing significantly affects recovery after hand tendon repair at Jaipur Hospital. Primary repair within 24 hours gives the most straightforward surgery and reliable healing. Delayed primary repair up to two weeks is also effective if tissues are healthy. Late presentation often requires a two-stage tendon graft, which has a longer rehabilitation and less predictable strength return.
In detail
Early repair allows direct end-to-end suture before tendon ends retract and scar. Evidence indicates that overall rupture rates have decreased over time with modern techniques, but the interval from injury to surgery remains a key factor. Late repairs have a higher overall complication rate.
Chronic injuries with a tendon gap need a graft, usually the palmaris longus, and two operations spaced months apart. Nerve recovery, if a nerve was also cut, depends on the delay; earlier nerve repair gives better sensory return.
The median interval for late tendon rupture after previous fixation is around nine months, showing that delayed problems can arise. Early surgery followed by a structured therapy protocol yields over 80 percent good or excellent outcomes in zone two repairs.
A common belief
Some people wait hoping the finger will move again.
What actually happens
It will not. The tendon retracts and scars, turning a one-hour repair into a two-stage reconstruction.
Your next step at Jaipur Hospital
Present to the emergency department at Jaipur Hospital as soon as possible after a hand laceration. If the injury occurred days or weeks ago, book an urgent outpatient appointment. The surgeon will assess whether primary, delayed, or graft reconstruction is needed. Early referral improves your final hand function.
How long might nerve or tendon recovery take for hand tendon repair?
In short
Tendon healing takes about three months to regain full strength at Jaipur Hospital. Protected motion starts the day after surgery and continues for six weeks in a dorsal splint. Light use begins at six to eight weeks. Nerve recovery, if a nerve was also repaired, is slower: about one millimetre per day, so return of sensation can take six to twelve months depending on the level of injury.
In detail
The rehabilitation protocol follows three phases. Phase one (weeks 0-4): wound care, oedema control, and passive mobilisation using the Duran protocol every two hours. Phase two (weeks 4-8): active place-and-hold exercises, tendon gliding, and gentle grip.
Phase three (weeks 8-12): strengthening with a ball and progressive loading. Studies using the Strickland classification show excellent or good total active motion in about 66 percent of patients at six months. Grip strength is good in 64 percent. Nerve regeneration is tracked by Tinel's sign advancing distally; full sensory return varies widely.
- Studies using the Strickland classification show excellent or good total active motion in about 66 percent of patients at six months.
- Grip strength is good in 64 percent.
A common belief
Many patients think the hand is normal once the stitches come out.
What actually happens
The tendon is still weak at two weeks. Removing the splint early or skipping exercises causes rupture or stiffness that cannot be fixed later.
Your next step at Jaipur Hospital
You will see the hand therapist before discharge and then weekly for the first month. The splint is adjusted at four and six weeks. Full unrestricted activity is usually allowed at twelve weeks. Attend all therapy sessions; they are as important as the surgery.
What hand therapy, splinting, or protection will be needed for hand tendon repair?
In short
After hand tendon repair at Jaipur Hospital, you will wear a dorsal blocking splint full-time for six weeks. The wrist is held at 30 to 40 degrees flexion, metacarpophalangeal joints at 60 to 70 degrees flexion, and interphalangeal joints in extension. A hand therapist starts passive exercises on day one using the Duran protocol every two hours.
In detail
The splint position changes at four weeks: wrist 10 to 15 degrees flexion, metacarpophalangeal joints 15 to 25 degrees flexion. At six weeks the wrist is neutral, metacarpophalangeal joints 15 degrees flexion. The splint is removed after eight weeks.
Therapy progresses through three phases: passive mobilisation weeks 0-4, active place-and-hold and tendon gliding weeks 4-8, strengthening with a ball weeks 8-12. Evidence shows early controlled motion reduces adhesion formation by 57 percent compared to immobilisation.
The epitendinous suture used during repair lowers re-operation risk by 84 percent. Compliance with the splint and exercise schedule is the single biggest factor in achieving good motion.
- Evidence shows early controlled motion reduces adhesion formation by 57 percent compared to immobilisation.
- The epitendinous suture used during repair lowers re-operation risk by 84 percent.
A common belief
Some patients think they can move the finger freely once the pain settles.
What actually happens
Early active motion without the splint raises the rupture rate to five percent. The splint protects the repair while allowing controlled gliding.
Your next step at Jaipur Hospital
You will receive the splint before leaving the hospital. The therapist will teach you the exercises and give a written home programme. Follow-up visits are weekly for the first month, then fortnightly. Do not remove the splint or do extra movements.
Could stiffness, numbness, or weakness persist despite treatment for hand tendon repair?
In short
Yes, some stiffness, numbness, or weakness can persist after hand tendon repair at Jaipur Hospital. Even with good surgery and therapy, studies report fair or poor total active motion in about 34 percent of zone 2 repairs at six months. Grip strength remains below normal in 36 percent. If a nerve was cut, full sensation may not return, especially in older patients or long delays.
In detail
Adhesion formation is the main cause of stiffness; it occurs in about four percent of repairs despite modern multi-strand core sutures and early motion protocols. Tendon rupture happens in four percent, usually between six and twenty-six months after surgery.
The flexor pollicis longus is the most commonly ruptured tendon. Nerve regeneration is unpredictable; about one millimetre per day is typical, but scar tissue at the repair site can block axons.
Patients with diabetes, smoking history, or late presentation have higher rates of residual stiffness and weaker grip. Tenolysis can release adhesions later, but results are variable.
A common belief
People expect a full return to normal.
What actually happens
The biology of tendon healing and nerve growth limits that. Adhesions and late rupture are known risks even with perfect technique.
Your next step at Jaipur Hospital
Your surgeon will discuss realistic goals before surgery based on the zone of injury, time since injury, and your general health. Regular therapy attendance and splint compliance give the most suitable chance of a good result. If stiffness persists at six months, tenolysis may be considered.
Costs, insurance and your care
Get an overview of billing, insurance coverage, and payment options for your care.
How will appearance, function, and realistic expectations be discussed for hand tendon repair?
In short
At Jaipur Hospital, your surgeon will discuss appearance, function, and realistic expectations during the preoperative consultation. The surgeon explains the likely range of motion, grip strength, and any visible scar or contour change. You will receive a clear picture of what the hand can achieve after rehabilitation.
In detail
The discussion is based on evidence from zone two repair studies showing over 80 percent good or excellent outcomes, but also that fair or poor results occur in about one-third of patients.
The surgeon explains the phased rehabilitation timeline: splinting for eight weeks, therapy for twelve weeks, and full strength at three months. Potential complications such as adhesion formation (around four percent), rupture (around four percent), and the possible need for tenolysis are outlined.
If a nerve was also injured, the slow and uncertain nature of sensory recovery is explained. The surgeon also describes the surgical scar, which is usually on the palm or finger volar aspect, and any temporary swelling or stiffness. This informed consent process ensures you understand the commitment required for therapy.
A common belief
Some patients assume the hand will be normal in weeks.
What actually happens
The surgeon makes clear that three months of therapy is needed and one-third may have only fair motion. Honest expectations improve satisfaction.
Your next step at Jaipur Hospital
You will have time to ask questions before signing the consent form. The hand therapist may also join the discussion to explain the exercise regimen. Bring a family member or attendant if you wish.
What qualifications and experience should the treating clinician have for hand tendon repair?
In short
At Jaipur Hospital, hand tendon repair is performed by surgeons with formal training in plastic surgery or orthopaedic surgery and specific experience in microsurgical tendon repair. The operating surgeon holds a recognised postgraduate qualification (MCh or DNB) and is credentialed by the hospital for hand and microsurgery procedures.
In detail
Tendon repair, especially in zone two, requires microsurgical skill to handle the flexor tendon sheath, pulleys, and adjacent neurovascular structures. The surgeon must be proficient in multi-strand core suture techniques and epitendinous suture placement, which evidence shows reduce adhesion and rupture rates.
Experience with primary, delayed primary, and two-stage tendon graft reconstruction is essential. The surgeon should also be familiar with postoperative rehabilitation protocols such as the Duran or early active motion programmes and work closely with a certified hand therapist.
Jaipur Hospital ensures that the surgical team meets these standards through its credentialing process and NABH accreditation requirements. The anaesthesia team is experienced in regional blocks (brachial plexus) and general anaesthesia for upper limb surgery.
A common belief
General surgeons may not have the microsurgical skill for zone two repairs or the experience to manage pulleys and grafts.
What actually happens
A dedicated hand surgeon works with a therapist and follows evidence-based protocols.
Your next step at Jaipur Hospital
You can ask about the surgeon's specific hand surgery fellowship training and case volume during your consultation. The hospital's plastic surgery and orthopaedics departments jointly manage complex hand injuries.
What is the expected cost of hand tendon repair in Jaipur?
In short
At Jaipur Hospital the typical price range for hand tendon repair is ₹35,000 to ₹90,000. The final amount depends on the complexity of the injury and the type of repair needed.
In detail
The cost reflects the surgical technique required. A primary repair done within 24 hours of injury is usually at the lower end of the range.
Delayed primary repair within two weeks or a two-stage tendon graft for chronic loss involves more operating time and materials, which increases the expense. Tenolysis to release adhesions after healing also adds to the total. The quoted range covers the operation, anaesthesia and routine hospital stay of daycare or one night.
A common belief
A simple primary repair within the first day costs less than a delayed repair or a two-stage graft for an old injury.
What actually happens
Tenolysis for scar release adds to the bill. The range includes surgery, anaesthesia and a daycare or one-night stay.
Your next step at Jaipur Hospital
Your surgeon will give you a detailed estimate after examining the injury and deciding which technique is appropriate. Bring any imaging or referral notes to the consultation. The hospital accepts RGHS, MAA Yojana, CGHS and several private insurers. To discuss your case and receive a personalised quote, book a consultation at Jaipur Hospital.
