Click here to find out more about how AskDr works for doctors
0

Flexor tendon Fdp laceration, dip joint cannot actively bend on its own

Hello, I am 6 months post op from flexor tendon repair. I lacerated my FDP with a kitchen knife and had a surgery on it 11 days after the injury.
The repair was a 4-strand suture and I was mobilized on the 7th day after surgery. Repair was on my pinky finger, laceration occurred at the crease where the tip of the pinky bends.
I am 6 months post op and still am not seeing much progression with my DIP joint and I have been extremely compliant with therapy. My doctor advised against tenolysis surgery due to risk of re-adhesion.  Would shockwave therapy be able to fix my problem? Do you think I should do tenolysis with a different doctor? Also it always feels like I have something stuck inside my finger.

Video of my range here: https://imgur.com/gallery/keKIZTt

Any suggestions to help improve my range would be appreciated. 
2
0
Dr. Ken J T
Facilitator
Doctor
12 Streak Score Doctors are able to put a streak together by performing an activity everyday
Hi ladymouse 

Sorry to hear about your injury! The small joints of the finger can be quite prone to develop stiffness after an injury and tendon repair. It’s quite common not to be able to regain full function/motion after such an injury.

Nonetheless, if the result is not satisfactory, it might be worth getting an ultrasound scan done to look at how the tendon repair is doing and also how much excursion (sliding) of the tendon is possible. Options for adhesions can include more therapy, a steroid injection and manipulation of the joint and surgery for adhesiolysis. As for shockwave, I’m not aware of data that it’s useful though I don’t see how it can be harmful. 

Hope that helps!
Reply
0
Recommended
Leave a review for Dr. Ken Jin Tan by clickinghere
@LadyMouse
Thank you! In your experience how long does it take for the swelling and aches to go away? It always feels like there’s something stuck inside my finger.
2
0
Dr. Hamid R
Facilitator
Doctor
9 Streak Score Doctors are able to put a streak together by performing an activity everyday
Dear @LadyMouse ,

Thank you for your detailed description of your problem. I am sorry that you are experiencing stiffness following your tendon repair. From what you have described, it seems like you had a Zone II flexor tendon injury. This zone historically had very poor results but results have improved due to advances in postoperative motion protocols. There is also risk of adhesion in Zone II injuries. It seems like you had a good robust repair and you had started early mobilization as well. The optimal time for tenolysis surgery is up for debates but in current literature ranges from from 2 to almost 25 months. Most commonly, it has been reported to be suitable from 6 to 9 months following the initial repair.  While there is  relatively strong evidence to supports the use of shockwave therapy other tendon conditions, I am not sure about its use in tendon adhesions. I would advise you to discuss your concerns and options with the surgeon-in-charge to come to a mutually agreeable treatment plan. Please take care!
Reply
0
Recommended
Leave a review for Dr. Hamid Razak by clickinghere
@LadyMouse
Thank you! In your experience how long does it take for the swelling and aches to go away? It always feels like there’s something stuck inside my finger.
Dr. Hamid Razak
Doctor
9 Streak Score Doctors are able to put a streak together by performing an activity everyday
Facilitator
@LadyMouse , it is quite difficult to predict and it really depends on a few factors. But as Dr Tan KJ has mentioned, it might be useful to get an US scan to check how the repair is doing, if there is scarring and how much the tendon can slide. These information will be useful to prognosticate your rehabilitation and also serve as a useful guide as to what the next best step for you might be. I hope that helps!