WHAT YOU SHOULD KNOW
After a laceration injury or surgery, the body forms scar tissue. Scar tissue prevents the back and forth movement of tendons that must happen for proper function of the joints that are controlled by those tendons. Scar tissue becomes mature and hard after around 3 months and can no longer be stretched. The joints themselves, if left in one position, will become permanently stiff or contracted.
MEDICAL HISTORY
Patients complain of stiffness, weakness, and poor function of the hand. There can be difficulty holding on to objects and loss of dexterity.
EXAMINATION
The doctor will measure both the passive motion in specific joints (the amount he can move the joint while holding it) and the active motion (the amount the scarred tendons are capable of moving the joint).
ADDITIONAL TESTS
Basic x-rays will determine how healthy the involved joints are.
TREATMENT OPTIONS
| NON-OPERATIVE | SURGICAL | |
| CONSISTS OF | Motion therapy exercises and splints | Removal of scar tissue from around joints and tendons |
| FEATURES | Stretches must be done hourly | Outpatient surgery, local anesthesia |
| ADVANTAGES | Avoids surgery | Can remove all the scar tissue |
| DISADVANTAGES | Only effective early on and for lesser severity conditions | Some scar reforms, patient must be highly committed to therapy |
RECOVERY
Therapy begins within 48 hours of surgery and consists of hourly motion exercises and powerful splints. The patient will have seen the amount of motion achieved at the time of surgery and should use that as a goal to work towards as a final result. The final result is always less due to the reformation of some scar tissue and occurs around 3 months from the time of surgery. In a few rare cases, the tendons will have been damaged so severely that reconstruction in two stages is needed with 2 separate surgeries each followed by 3 months of therapy for a total treatment time of 6 months.
