Children's Hospital Colorado

Tendon Injury

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What is a tendon?

A tendon is a band-like tissue that connects muscles to bone. When the muscles tighten, the tendons pull the bones and cause the joints to move, such as in the hand or fingers.

  • For example:
    • Extensor tendons are in the top of the hand and straighten the fingers.
    • Flexor tendons are in the on the palm side of the hand and bend the fingers.
  • A tendon sheath is a little tunnel the tendon slides through. This tunnel keeps the tendon in place next to the bone

What causes a tendon injury?

A tendon injury usually occurs when a tendon is damaged, such as being cut or ruptured (torn).

  • The area may not move normally or might feel weak.
  • The area may be painful or tender.
  • There might be numbness or tingling if a nerve was also damaged.

How is a tendon injury diagnosed?

A tendon injury is diagnosed by a physical examination. Your child’s doctor might order X-rays to look at the bones, to see if a piece of bone has pulled away and to be sure the bone is in correct position.

How is a tendon injury treated?

  • Treatment depends on the type of injury.
  • Treatment may include splinting alone or splinting and surgery to repair the tendon.
  • Your provider will decide if surgery is needed. Tendon repair surgery is done to bring back normal movement to a joint.
  • A cut flexor tendon usually requires surgery.

What to expect from tendon injury surgery

  • It is best to do surgery to repair a tendon injury as soon as possible (within 7-14 days after the injury).
  • The surgery will be done in the operating room under general anesthesia (the child is put to sleep).
  • Sometimes it is necessary to put the bone in the correct position. Small pins, wires or screws might be used to hold the bone straight while the tendon heals.
  • Sometimes the tendon will need to be sewn together, connecting the ends that are torn apart.
  • If there isn’t enough healthy tendon to reconnect, a tendon graft might need to be done. This is when a piece of tendon from another part of the body is used.
  • A tendon transfer (moving one tendon from one area to another) might be useful to bring back function to the area.
  • If a cut in the skin is made during surgery, it is closed with stitches.
  • If your child is sick any time during the week before surgery, it is important to call the Hand and Upper Extremity Program to find out if the surgery should be rescheduled. The hand nurse is available Monday through Friday for any questions you might have before the surgery.

Hand therapy

After surgery, your child with work with a therapist, 1-2 times per week for up to 12 weeks after their surgery. The first appointment is usually scheduled in the first 1-2 weeks after the surgery. This is a very important part of making sure the surgery is successful.

Why choose Children’s Colorado for your child’s tendon injury?

Our Hand and Upper Extremity Program team at Children’s Colorado provides a comprehensive, multidisciplinary approach to the care of your child. This means you have access to leading specialists from multiple departments who work together to treat your child.

Your child’s care team includes pediatric experts from orthopedic surgery, physical medicine, rehabilitation, occupational therapy and nursing.


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