Tendon Laceration
A cut tendon from a sharp injury, often in the hand or fingers
Quick Facts
- Type: Soft tissue injury
- Common cause: Cut from a sharp object
- Common site: Hand and fingers
- Key effect: Loss of movement in the affected part
Overview
Tendons are tough, rope-like cords of tissue that connect muscles to bones and transmit the force that produces movement. A tendon laceration is a cut or tear of a tendon, most often caused by a sharp object such as a knife, glass, or machinery. The hand and fingers are the most common sites because their tendons lie close to the skin.
When a tendon is cut, the muscle can no longer move the bone it was attached to, so the affected finger or joint may not bend or straighten properly. Tendon lacerations usually need prompt medical attention and often surgical repair, because a cut tendon generally does not heal back together on its own. With timely treatment and rehabilitation, many people regain good function.
Symptoms
The symptoms of a tendon laceration depend on which tendon is cut and how complete the cut is. Common signs include:
- A cut or wound over a tendon, often on the hand, wrist, or fingers
- Inability to bend or straighten a finger or joint normally
- Pain, especially when trying to move the part
- Weakness in the affected finger or limb
- An abnormal resting position of the finger
- Numbness, if a nearby nerve is also injured
A deep cut combined with loss of movement in a finger or joint should be treated as a possible tendon injury and evaluated promptly.
Causes
Tendon lacerations are caused by sharp injuries that cut through the skin and the tendon beneath:
- Knife and kitchen injuries: A common cause, especially of finger tendons.
- Broken glass: Cuts from glass, including putting a hand through a window.
- Tools and machinery: Saws, blades, and industrial equipment.
- Crush and severe injuries: Accidents that both cut and crush tissue.
Less commonly, a tendon can be torn rather than cut, but a true laceration involves a sharp object dividing the tendon.
Risk Factors
- Work with sharp tools, blades, or machinery
- Food preparation and kitchen tasks
- Contact sports or activities with broken glass or sharp edges
- Handling glass or sharp objects without protection
Diagnosis
A tendon laceration is diagnosed through examination of the wound and testing of movement:
- Examination: Inspecting the wound and testing whether the finger or joint can move against resistance.
- Movement testing: Checking each tendon's specific action to find which is cut.
- Nerve and circulation check: Assessing for injury to nearby nerves and blood vessels.
- Imaging: X-rays to look for associated fractures or foreign objects such as glass.
Treatment
Treatment usually involves repairing the tendon and protecting it while it heals. Care is often provided by a hand or orthopedic surgeon.
- Wound care: Cleaning the wound and preventing infection, sometimes with antibiotics and a tetanus update.
- Surgical repair: The cut tendon ends are stitched back together, as a divided tendon usually will not heal on its own.
- Splinting: A splint protects the repair and controls movement during early healing.
- Hand therapy: A guided rehabilitation program restores movement and strength while preventing stiffness and scarring.
Following the rehabilitation plan closely is essential, as the outcome depends heavily on protecting the repair and regaining motion gradually.
Prevention
- Use cutting tools carefully and keep blades sharp and well maintained
- Wear protective gloves when using saws, blades, or handling glass
- Follow safety guards and procedures when using machinery
- Clean up broken glass carefully and safely
- Keep hands clear of moving blades and equipment
When to See a Doctor
Seek prompt medical care for any deep cut, especially over the hand, wrist, or fingers, or if you cannot move a finger or joint normally after a cut. Seek emergency care if you have:
- Heavy bleeding that will not stop with firm pressure
- A deep wound with loss of movement, numbness, or a finger that looks pale
- A wound contaminated with dirt, glass, or debris
Early evaluation and repair give the best chance of regaining full function, so do not delay even if the cut looks small on the surface.
Frequently Asked Questions
Can a cut tendon heal without surgery?
A fully divided tendon usually does not heal back together on its own, because the cut ends pull apart. Most complete tendon lacerations need surgical repair to reconnect the ends, followed by hand therapy to restore movement.
How do I know if I have cut a tendon?
A clue is a deep cut combined with the inability to bend or straighten a finger or joint normally, or weakness when trying to move it. Even small-looking cuts can divide a tendon, so any wound with loss of movement should be checked promptly.
Why is hand therapy important after a tendon repair?
After repair, a tendon must move gradually and in a controlled way to regain glide and strength while avoiding stiffness and scarring. A guided hand therapy program is one of the most important factors in how well function returns.
What should I do right after a deep hand cut?
Apply firm pressure with a clean cloth to control bleeding and seek prompt medical care. Do not ignore the injury even if bleeding stops, because the tendon underneath may be cut. Mention any loss of movement or numbness to the clinician.
When is a tendon laceration an emergency?
Seek emergency care for heavy bleeding that will not stop, a deep wound with numbness or a pale finger, or a wound contaminated with debris. These need urgent attention to control bleeding, prevent infection, and protect the tendon and nerves.
References
- American Academy of Orthopaedic Surgeons (OrthoInfo). Flexor Tendon Injuries.
- American Society for Surgery of the Hand. Tendon Injuries.
- MedlinePlus, U.S. National Library of Medicine. Tendon injury.
- Mayo Clinic. Cuts and lacerations.