Tendon repair (Surgical repair of a divided tendon (tenorrhaphy))

What is tendon repair?

Tendons are the strong, cord-like structures that connect muscle to bone. When a tendon is cut or torn — most often by a knife, glass, a deep cut or a crush injury — the muscle can no longer pull on the bone, so a finger, thumb, wrist or other joint stops moving properly. Tendon repair is the operation to stitch the two ends back together so movement can return.

The surgery is only the first part. Because a repaired tendon is weak at first and tends to stick to the tissue around it, the result depends heavily on hand therapy: a carefully staged programme of splinting and exercises over several weeks. Two people can have an identical-looking repair and very different outcomes depending on the injury and how well rehabilitation goes.

It is important to be realistic. A repaired tendon is rarely as good as it was before. Many people regain very useful movement, but some stiffness, weakness or loss of full range can remain, and a second operation is sometimes needed. Repairs in the 'flexor' tendons that bend the fingers (especially in the palm and finger) are particularly demanding.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your surgery

• Tendon injuries are often treated urgently, so there may be little time to prepare — tell the team about your dominant hand, your job and your hobbies.
• Tell your surgeon about diabetes, smoking, blood-thinning medicines and any previous hand injuries or surgery.
• Stopping smoking or nicotine helps healing and lowers the risk of wound and tendon problems.
• Arrange time off work; manual and heavy jobs usually need longer, and you may be in a splint for around six weeks.
• Arrange a lift home and help at home, as you will have one hand out of action for daily tasks.
• Ask before surgery who will provide your hand therapy and how soon it will start, because early, supervised movement is central to a good result.
• Remove rings and bring loose clothing that fits over a bulky splint or dressing.

What happens

The operation may be done under local anaesthetic (numbing just the hand), a regional block (numbing the whole arm), or a general anaesthetic. The surgeon opens the skin over the injury, finds the cut tendon ends — which can retract some distance away — and stitches them back together with fine, strong sutures designed to hold while still allowing some early movement.

Nerves and blood vessels lie very close to tendons, so the surgeon also checks these and repairs them if needed. The wound is closed and the hand is put into a protective splint, usually with the joints in a position that takes tension off the repair. Most people go home the same day.

You will normally be referred to a hand therapist (a specialist physiotherapist or occupational therapist) within days. They fit or adjust your splint and teach you exactly which movements to do — and which to avoid — so the tendon glides and does not stick down, without pulling the repair apart.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

The two biggest issues specific to tendon repair are the tendon sticking down (adhesions) and re-rupture — and these pull in opposite directions, because early movement reduces stiffness but slightly raises the chance of the repair coming apart. This is why following your hand therapist's instructions precisely matters so much. Smoking, diabetes and crush or contaminated injuries all worsen the odds. Ask your surgeon how complex your particular injury is and what your realistic best and worst outcomes might be.

Published figures to discuss

Outcomes after tendon repair vary widely with the injury type, the zone of the hand involved, whether nerves or vessels were also damaged, the surgeon's technique and — crucially — the quality and timing of hand therapy. Published rates therefore differ between studies and should be read as a guide, not a promise. Re-rupture and adhesion rates in particular depend on the rehabilitation protocol used.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery from tendon repair is a gradual, hands-on process measured in months, not days. The repaired tendon is at its weakest in the first few weeks, so the early phase is about protecting it in a splint while doing the exact exercises your therapist prescribes.

• Swelling and stiffness that ease slowly over weeks
• A finger that feels weak and moves less than the others at first
• A firm, sensitive or slightly raised scar that softens over months
• Aching after therapy exercises, which is part of regaining glide
• Slow, step-by-step progress rather than a sudden return to normal

Aftercare

• Wear your splint exactly as instructed — taking it off too soon is a common cause of re-rupture.
• Do your hand-therapy exercises as prescribed; doing too much or too little both cause problems.
• Keep the hand elevated in the early days to reduce swelling.
• Keep the wound clean and dry and follow advice on dressings and stitch removal.
• Do not grip, lift, push or carry anything until your team says it is safe.
• Stop smoking, as it slows tendon and wound healing.
• Attend all hand-therapy and surgical follow-up appointments — they are essential, not optional.
• Contact the team promptly if you feel a sudden give, pop or loss of movement in the finger.

• Hand-therapy appointment booked and start date confirmed
• Splint care and wearing instructions understood in writing
• Time off work arranged (longer for manual jobs)
• Help at home for one-handed daily tasks
• A sling or way to keep the hand elevated
• Clinic's contact number for problems saved
• Plan for getting to regular therapy sessions

Scars and how they heal

There will be a scar over the repaired tendon, and sometimes a second small scar if a graft was taken from elsewhere. Scars are firm, pink and sometimes sensitive at first and usually soften and fade over several months. Hand therapists often teach scar massage and may use silicone gel to help. Scars over the palm or finger creases occasionally tighten and need attention.

⚠ Get urgent help if…

• A sudden pop, give or loss of the ability to bend or straighten the finger — possible re-rupture
• Spreading redness, heat, swelling or discharge from the wound (signs of infection)
• A fever or feeling generally unwell after surgery
• Severe or increasing pain not eased by your usual painkillers
• The fingertip turning pale, blue, very cold or numb
• A splint that becomes too tight, soaked or damaged

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result means the finger or joint moves usefully again with reasonable strength, allowing you to return to work and daily activities. This is rebuilt over months through therapy rather than seen immediately after surgery. Even a technically perfect repair may not restore completely normal movement, and the final outcome depends as much on the injury and your rehabilitation as on the operation itself. Your surgeon and therapist should be honest about what is realistic for your specific injury.

Once a tendon repair has fully healed and movement has settled, it is generally durable for everyday use. However, the repaired area can stay slightly weaker than the original tendon, and a small number of repairs are re-injured, develop late adhesions, or need further surgery such as a release of scar tissue. Keeping up the strengthening and flexibility your therapist recommends helps protect the long-term result.

Combining with other procedures

Tendon injuries often involve nearby nerves and blood vessels, which may be repaired during the same operation; this can lengthen recovery and affect sensation. Where several structures are damaged, surgeons sometimes stage the reconstruction over more than one operation. Your team will explain what was found and repaired, as this changes your rehabilitation plan.

Follow-up & long-term care

You will usually be seen by the surgical team for wound checks and stitch removal in the first couple of weeks, and by a hand therapist regularly — often weekly — for up to about three months. Later reviews check strength, movement and whether any further treatment is needed. Tell the team straight away if you feel a sudden change in the finger's movement.

• Keep up prescribed strengthening and stretching exercises until discharged
• Use scar massage or silicone as advised to keep the scar supple
• Build back up to heavy or repetitive hand use gradually
• Protect the hand at work or sport while it is still regaining strength

Revision and secondary surgery reality

• A second operation to release adhesions (tenolysis) is sometimes needed if the tendon sticks down despite therapy.
• Re-rupture may require re-repair or, later, a tendon graft.
• Complex or old injuries may be planned as two-stage reconstructions from the outset.
• Some loss of full movement or strength may remain even after revision surgery.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

• Early referral to a specialist hand therapist with a written splinting and exercise plan.
• Regular therapy reviews, often weekly, for up to around three months.
• Clear written warning signs for re-rupture and infection, with a named contact route.
• Honest, staged goal-setting about movement, strength and return to work.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The surgeon's fee and how complex the injury is (number of tendons, zone of injury, associated nerve or vessel damage)
• Anaesthetic or regional block and the theatre or facility fee
• Whether a tendon graft or staged reconstruction is needed
• The number of hand-therapy sessions required, which can be many over several months
• Custom splints and any specialist equipment
• Follow-up appointments and treatment of any complications such as a tendon release

• The surgeon's fee and the facility/theatre fee
• Anaesthetic or regional block fee
• How many hand-therapy sessions are included, and what they cost after that
• Cost of splints, dressings and follow-up appointments
• What happens, and who pays, if the repair ruptures or further surgery is needed
• The cancellation policy and what is covered if a complication occurs

On the NHS? Tendon injuries are normally repaired on the NHS as urgent trauma care; private care is mainly chosen for speed, a particular surgeon, or quicker access to hand therapy rather than because the NHS does not provide it.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a surgeon safely

• Check your surgeon is on the GMC Specialist Register for this area.
• Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
• You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
• Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good surgeon will welcome every one of these.

• How complex is my injury, and what is a realistic best and worst outcome?
• Which tendons were cut, and were any nerves or blood vessels also repaired?
• Who will provide my hand therapy, and how soon will it start?
• How long will I be in a splint, and when can I start using the hand?
• What are the chances I might need a second operation, such as a tendon release?
• When can I expect to return to my specific job and hobbies?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the surgeon who carries out my operation, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this operation not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified surgeon for tendon repair

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Hand tendon repair University Hospitals Plymouth NHS Trust — Zone 1 & 2 flexor tendon repair rehabilitation Cochrane — Recovering movement after flexor tendon repair surgery Current clinical opinion on flexor tendon surgery and rehabilitation — PMC

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.