Tendon, Artery, and Nerve Damage

About Tendon, Artery, and Nerve Damage

Hand injuries that involve tendons, arteries and nerves are complex and frequently coexist. Together these structures provide movement, blood flow and sensation, so even apparently small wounds can leave significant disability if any one component is missed. Careful examination, accurate diagnosis and timely repair are essential for a meaningful long-term recovery.

Tendons are tough, cord-like structures that transmit power from the forearm muscles into the fingers and thumb. Flexor tendons run on the palm side and bend the fingers for gripping, while extensor tendons run on the back of the hand to straighten the fingers and wrist. Injury to either group disrupts grip, pinch and the ability to open the hand.

Tendon injuries usually result from cuts, sudden forceful pulls or crush injuries from accidents, machinery, glass or household tools. Patients describe an inability to bend or straighten a finger, weakness on gripping and pain on movement. Tendon injuries are often associated with bone fractures, so X-rays are taken in our Lucknow clinic alongside clinical testing.

The hand receives dual blood supply through the radial and ulnar arteries, with each finger also fed from both sides. This redundancy can save a hand, but injuries to both major arteries leave the limb white, cold and senseless. Sharp cuts, crush and avulsion injuries are the common mechanisms, often requiring urgent vessel repair.

Arterial injuries are emergencies. Bleeding is controlled with direct pressure and limb elevation while transfer to surgery is arranged. Veins can sometimes be tied off safely, but arteries should be repaired wherever possible to restore flow. Dr. Agarwal, FRCS Edinburgh, plans simultaneous tendon, vessel and nerve repair to give the best chance of regaining function.

What to expect

• Detailed history and structured hand examination
• Imaging and Doppler assessment when needed
• Microsurgical repair under tourniquet control
• Direct tendon repair or grafting as required
• Vessel repair to restore radial and ulnar flow
• Nerve coaptation for median, ulnar or radial injuries
• Coordinated hand therapy and splinting

Recovery

• Splinting in a tendon-protective position
• Antibiotics and analgesics during early healing
• Hand therapy starting within days when safe
• Gradual progression from passive to active motion
• Sensory re-education for nerve recovery
• Heavy gripping resumed only after surgeon clearance