It's happened to most of us. While cooking, a knife slips and slices your hand. A tiny cut in the wrong place could mean lifelong, debilitating damage.
Now surgeons have a way to help some patients fully heal.
Ten-year-old William Ross lets his fingers do the talking, but an accident almost cut his playing days short.
"William was making his lunch for school for the next day," his mother, Kim Ross, said.
"I took a paper towel and started cleaning this off like this," William said as he showed what he did.
The serrated knife sliced through three fingers.
"He burst out onto the patio and blood, or course, was just gushing," Kim recalled
He cut the main tendon in his ring finger.
"Once he cut that, he essentially had almost a useless digit," Dr. Wesley Paul Thayer of Vanderbilt University said.
Experts call this part of the hand no man's land, as surgery here rarely results in a full recovery. So Thayer decided to try something new. "In William's case, we used a newer suture called fiberwire that we found in our lab to be at least 30 percent stronger than previous, than other sutures that we use."
Fiberwire is made of braided polyester. It's more durable than its nylon predecessor. But that was just half the job. Young patients normally get fitted with a rigid cast.
"We don't trust them with the repair. If they go out and overdo it, let's say they swing on monkey bars or they wrestle with their dog or with their siblings, they can tear apart the tendon," Thayer said.
His super suture allowed William to wear a flexible splint. That meant an early jump on physical therapy instead of waiting the standard six weeks.
The fiberwire suture is used in surgical procedures ranging from Achilles tendon repairs to rotator cuff repairs.
OUCH! MY HAND HURTS: Flexor tendon injuries are a very common occurrence. Many people experience these injuries daily. Often, we don't realize how important our hands are in our daily activities, watching TV, driving to work, writing a letter or simply talking, until a hand injury occurs. Experts on E-hand.com say that the flexor tendons are smooth, flexible strings that flex the fingers on each hand. When flexor tendons are severed, the part connected to the muscle is usually cut back and pulled into the palm. Many people suffer from stiffness when dealing with flexor tendon injuries. The American Academy of Orthopaedic Surgeons gives five symptoms to look out for if you are unsure if you have a flexor tendon injury. Signs and symptoms include: the inability to bend joints on the finger, pain where the finger is bent, open injuries such as cuts, on the palm side of the hand, swelling on the joints nearest to the fingertips, and tenderness along the finger or palm side of the hand.
FIXING FLEXOR TENDON INJURIES: To repair flexor tendon injuries, doctors have options: hand therapy to reinstate immediate movement of the fingers, finger splints or casts and the most common option is surgery. To repair a split flexor tendon, doctors sew two small ropes together, from end to end. Next, special stitches are used on the inside and outside of the injury. This may seem like no big deal, however, if the tendon is cut or pulled off of the bone, then, stitches are required through the bone in order to secure the tendon back to the bone. In some cases, special implants are used to secure the tendon and bone if doctors are unable to stitch through the existing bone. If a splint does not cover the repair after surgery, the incisions can tear. Recovery usually takes about two months.
FIBERWIRE: NEW SUTURE: FiberWire is a suture made out of multi-stranded long chain polyethylene core with polyester braided jackets. These materials allow FiberWire to be stronger, softer and abrasion resistant, compared to traditional sutures. FiberWire also eliminates suture breakage during knot tying,
WHAT YOU CAN DO: There is no true prevention for flexor tendon injuries. This is because almost all flexor tendon injuries are accidental. Mindfulness of the risks and consequences of injuring the flexor tendon is all doctors can advise. When and if a flexor tendon injury does occur experts say ice should be immediately applied and compression should occur to slow the flow of blood to the injured finger.
For more information:
Craig Boerner
Vanderbilt University Medical Center
Craig.boerner@vanderbilt.edu
(615) 322-4747
