TENDON REPAIR

General Information

DEFINITION-Reattaching tendons to their connective tissue or sewing sections of broken tendons together.

BODY PARTS INVOLVED-Injured tendons, most frequently in the hand, foot, ankle, wrist, shoulder, hip, knee and elbow.

REASONS FOR SURGERY-Restoration of normal function of joints or tissue surrounding tendons.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Obesity; smoking; alcoholism.
• Poor nutrition.
• Recent or chronic illness.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES-Hand surgeon or general surgeon.

WHERE PERFORMED-Hospital, outpatient surgical facility or emergency room.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays of the injured part.
• After surgery: Blood studies.

ANESTHESIA

• Local anesthesia by injection.
• Spinal anesthesia by injection.

DESCRIPTION OF OPERATION

• An incision is made over the injured tendon.
• The severed ends of the tendon are located and sewn together. If the tendon has been injured severely, a tendon graft may be required.
• If necessary, tendons are reattached to surrounding connective tissue.
• The surgical area is examined for injuries to nerves and blood vessels.
• The skin is closed with sutures, which usually can be removed about 10 days after surgery.
• Usually, the injured part is kept rigid with a splint or plaster cast.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Partial loss of function in joint served by the injured tendon(s).

AVERAGE HOSPITAL STAY-0 to 1 day.

PROBABLE OUTCOME-Expect complete healing without complications. Allow about 1 month for recovery from surgery.

Postoperative Care

GENERAL MEASURES

• If the wound bleeds during the first 24 hours after surgery, press a clean tissue or cloth to it for 10 minutes.
• A hard ridge should form along the incision. As it heals, the ridge will recede gradually.
• Use an electric heating pad, a heat lamp or a warm compress to relieve incisional pain.
• Bathe or shower as usual after the splint is removed.
• Between bathings, keep the wound dry with a bandage for the first 2 or 3 days after the splint is removed. If a bandage gets wet, change it promptly.
• See Care of Casts in Appendix.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Avoid vigorous exercise for 6 weeks after surgery. > Resume driving 4 weeks after returning home.

DIET--No special diet.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• Skin below the cast becomes cold, discolored or numb.
• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience nausea or vomiting.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.