Tendon Injuries and Lacerations

mallet-finger-illustration-relabel-baseball-finger-as-mallet-finger_shutterstock_98475905-300x300f4563f26b7584652bf5521ff6282a2c5.tmb-mediumThe tendons of the hand and wrist are mostly long white cords of tissue that connect the muscles to the bones and allow for movement. Most of the muscles are located in the forearm, and most of the tendons travel through tight compartments in the wrist and fingers before attaching to their target bones. When the forearm muscles contract, they pull on the tendons much like puppet strings control a puppet. When a tendon ruptures or is cut, function is lost. When tendons are inflamed or scarred, they may not glide smoothly through the hand causing pain, clicking, or stiffness


There are many causes of both acute and

  • Lacerations (cuts) and puncture wounds to the hand/wrist/forearm
  • Even small cuts to the skin can result in multiple cut tendons
  • Blunt trauma or sudden heavy loads may cause tendon rupture without a cut
  • Minor “Jamming” injuries of the fingers may cause tendon rupture (mallet finger)
  • Inflammatory diseases (rheumatoid arthritis) can cause spontaneous tendon ruptures
  • Overuse can cause chronic tendon injuries
  • Prior surgeries and hardware implants can result in tendon adhesions or ruptures

Signs and Symptoms

Symptoms of a tendon injury can include:

  • Sudden loss of wrist or finger movement after a cut, puncture or blunt injury
  • Drooping of the end of the finger after jamming injury (mallet finger)
  • Clicking, popping, or grinding sensation with wrist/finger movements
  • Pain or stiffness in the hand or finger along the tendons.

Is There a Test For Tendon Injuries?

Most cases of tendon laceration or injury can be detected on physical examination. Occasionally an MRI is ordered to identify where the tendon is injured, and whether or not it has retracted from the site of injury due to the pull of the muscle.



We often start with nonoperative treatments for chronic tendon injuries:

  • Activity modification recommendations
  • Splinting
  • Anti-inflammatory medications
  • Steroid injections
  • Hand therapy


Operative Treatment:
Acute tendon lacerations and ruptures almost always require urgent surgical repair for the best outcome. Once the tendon retracts and scars in, it can be difficult or impossible to repair, and generally will not heal on its own. If you have sustained a cut to your fingers, hand, or wrist, and are no longer able to normally move a finger, please seek urgent medical attention. Even small skin wounds can hide a surprising amount of deep damage to the tendons and nerves. Cut tendons diagnosed within the first few days can usually be surgically repaired. The procedure typically involves a regional numbing block of the arm, followed by some sedation in the OR, and suturing of the cut or ruptured tendons. After surgery, it is critically important to follow all your surgeon’s recommendations for activity limitations, splinting, and hand therapy to reduce the risk of permanent stiffness and rupture of the tendon repair.


Ready to Confirm a Diagnosis and Fix the Problem or Just Want to Learn More?

Our Board-Certified Orthopaedic Hand and Wrist Surgeons Eric Angermeier, MD and Kyle Kokko, MD, PhD, are here to help! They can often diagnose the problem in one visit, and get you started with a treatment plan ranging from simple splinting and hand therapy to injections or surgical options when needed.

Call today for a clinic or telehealth appointment! 854-423-4263