A finger that will no longer bend or straighten

You are cutting something in the kitchen when the knife slips and cuts your finger. The wound looks minor, but suddenly you cannot bend or straighten that finger, no matter how hard you try.

Or, while playing, the ball hits the tip of your straightened finger, something tears inside it, and from then on the fingertip droops limply and you cannot lift it yourself. This is not an ordinary bruised finger. It is an injury to a flexor or extensor tendon.

What is actually happening?

A tendon works like a drive cable connecting an engine to a wheel: the forearm muscle contracts, and the tension in this cable transfers movement to the finger. When the cable ruptures, the engine still works—you feel the muscle tense—but the finger stops responding: it cannot bend or straighten. Depending on the extent and level of the injury, some or all joints may have limited flexion or extension. The flexor tendons lie on the palmar (inner) side, while the extensor tendons lie just beneath the skin on the dorsal (outer) side, so they are particularly vulnerable to being cut.

Most often these are cut wounds, for example from glass or a knife, that cut a strongly tensioned tendon lying just beneath the skin. Less often, the tendon ruptures without a visible wound when the finger is suddenly and heavily loaded while under tension or in an axial injury.

How can you recognize it?

  • you cannot bend or straighten the finger at a specific joint despite trying,
  • a visible wound on the palmar or dorsal side of the hand at the site of the injury,
  • pain and swelling around the injured area,
  • the fingertip droops limply and cannot be straightened on its own.

Why you should not wait

An unrepaired tendon retracts toward the muscle and gradually loses its elasticity. The longer this lasts, the harder it is to bring its ends together and stitch them during surgery.

Repair performed quickly, ideally within the first 3-4 weeks after the injury, offers a clearly better prognosis than a delayed operation, when a one- or two-stage tendon reconstruction is often already needed, initially using a tendon prosthesis and at a later stage a graft.

How we help

We begin by examining the wound and assessing finger function, which show which tendon is injured and to what extent. We also check sensation and blood supply to the finger to rule out damage to nerves or vessels running in the same area. If the wound appears infected, we take a swab to help select the appropriate antibiotic before the procedure.

We often supplement the diagnostic work-up with ultrasound to assess the extent and severity of the injury, the distance between the tendon stumps, and possible associated injuries.

We repair the injured tendon surgically, reconnecting its ends into one whole. If the injury also includes a nerve transection, we repair the nerve during the same procedure.

In extensive or longstanding injuries, when simple suturing is not possible, we reconstruct the tendon with a graft taken from another tendon that is less important functionally, or connect it to an adjacent tendon to restore the lost movement.

There is one goal: a finger that bends and straightens at our command again.

Book a consultation

If you have suffered such an injury, do not wait, because repair becomes more difficult with each day. Make an appointment for a consultation. We will assess how serious the injury is and tell you what procedure is needed.