MANUAL MINORS
A rupture of the wrist or hand tendons involves a partial or complete tear of the tendons, which are structures responsible for connecting muscles to bones, allowing movement. This injury can be caused by direct trauma, chronic overload, or deep cuts. Symptoms include sharp pain, loss of motor function in the fingers or wrist, swelling, and in cases of complete rupture, the inability to move the affected area.
Diagnosis
Diagnosis is made through a physical examination, where the inability to extend or flex certain fingers or the wrist is observed. Clinical tests, such as the inability to perform active movements, are key. Ultrasound or MRI can confirm the diagnosis and assess the extent of tendon damage.
Differential Diagnosis
Condition | Distinctive Characteristics |
|---|---|
Tendinitis | Pain with movement but no complete loss of motor function. |
De Quervain’s tenosynovitis | Pain on the radial side of the wrist with swelling, but no loss of finger movement. |
Carpal tunnel syndrome | Paresthesia and weakness in the hand, but without tendon tear or rupture. |
Wrist sprain | Pain and swelling after trauma, but no loss of finger function. |
Emergency Management
In managing a tendon rupture, it is crucial to immobilise the affected wrist or hand to prevent further damage. Pain control with analgesics, along with the administration of non-steroidal anti-inflammatory drugs (NSAIDs), is essential. If there is an open wound, infection control measures, including irrigation and antibiotic coverage, are required, especially if the injury was caused by a cut.
Definitive Treatment
Definitive treatment for tendon ruptures is generally surgical, as most torn tendons do not heal on their own. Surgery involves repairing the affected tendon through suturing, and in more complicated cases, a tendon graft may be necessary. After surgery, temporary immobilisation and an intensive physiotherapy programme are required to restore function and prevent stiffness.
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