From the Research
Yes, a laceration can cause a delayed flexor tendon rupture, as supported by the most recent and highest quality study available 1. When a laceration partially damages a flexor tendon, the remaining intact fibers may continue to function initially but gradually weaken over time, eventually leading to complete rupture days, weeks, or even months after the initial injury. This delayed rupture typically occurs because the partially damaged tendon continues to bear mechanical stress during hand movements, causing the remaining fibers to progressively fail. Some key points to consider in the management of flexor tendon injuries include:
- The importance of thorough clinical assessment and often not isolated injuries, as highlighted in 2
- The need for a detailed understanding of flexor tendon anatomy and spatial relationships, especially when repairing multi-tendon injuries, as discussed in 2
- The principles of flexor tendon repair, including a strong suture construct, minimizing gap formation between tendon ends, preserving tendon blood supply, and providing a smooth repair interface, as outlined in 2
- The potential complications of flexor tendon injuries, including adhesions, tendon rupture, infection, and a high reoperation rate for zone 2 repairs, as noted in 1 Patients may experience a sudden loss of finger flexion ability, often accompanied by a popping sensation when the tendon finally ruptures. Risk factors for delayed rupture include:
- Inadequate initial wound exploration
- Missed partial tendon lacerations during examination
- Infection
- Poor blood supply to the injured area Anyone who has sustained a hand laceration should be vigilant for new or worsening symptoms such as decreased finger movement, weakness in grip, or inability to bend a finger, even weeks after the initial injury has healed. Prompt surgical evaluation is essential if delayed tendon rupture is suspected, as surgical repair becomes more challenging with increased time since injury due to tendon retraction and scarring, as emphasized in 1.