Tendon and Soft Tissue Conditions

Tendon and Soft Tissue Conditions

Tendons and soft tissues make the fine, precise movements of the hand possible. When these structures are affected by injury or disease, the result can be pain, restricted movement, or loss of strength — even during the simplest everyday tasks. Modern treatment approaches range from conservative measures to specialized surgical procedures.

Trigger Finger

In trigger finger, the flexor tendon becomes constricted at the level of the annular pulleys of the finger. The tendon can no longer glide freely, causing it to catch temporarily when the finger is bent or straightened. Typical symptoms include a painful snapping or locking of the affected finger, along with tenderness in the palm.

In the early stages, anti-inflammatory treatments or injections can bring noticeable improvement. If symptoms persist, a minor outpatient procedure is usually performed to release the constricting annular pulley. Finger mobility is often restored immediately after surgery, and most patients are able to return to their normal daily activities within just a few days.

Tendon Sheath Inflammation

Tendon sheath inflammation commonly develops as a result of repetitive strain, unaccustomed movements, or underlying inflammatory conditions. Typical symptoms include activity-related pain, swelling, and restricted movement. The thumb side of the wrist is particularly often affected, in the form of a condition known as de Quervain's tenosynovitis. In many cases, rest, splinting, or anti-inflammatory measures alone lead to significant improvement. Injections, shockwave therapy, and treatment by a hand physiotherapist are additional options. When conservative treatments fail to achieve the desired outcome, surgical decompression of the affected tendon sheaths may be advisable. Recovery is generally swift, and the hand's load-bearing capacity gradually returns within a few weeks.

Dupuytren's Disease

Dupuytren's disease is a benign condition of the connective tissue in the palm, in which nodular and cord-like changes develop over time. As the condition progresses, individual fingers increasingly adopt a bent position, making it harder to grip objects or fully straighten the hand. Treatment is generally only recommended when functional limitations begin to affect daily life. Depending on the findings, minimally invasive procedures or surgical intervention to remove the altered tissue may be considered. Follow-up treatment typically combines splinting with specialized hand therapy.

Ganglions, Soft Tissue Tumors, and Bone Cysts

Ganglions — commonly known as lumps — are benign outpouchings of joint capsules or tendon sheaths. Benign soft tissue tumors and bone cysts also occur relatively frequently in the hand and do not always cause symptoms. Treatment depends on the type, size, and location of the findings. Small, asymptomatic findings can often simply be monitored, while surgical removal may be advisable in cases of pain or functional impairment.

Tendon Injuries and Tendon Ruptures

The flexor and extensor tendons of the hand allow for the complex movements of the fingers and wrist. Injuries can result from accidents and lacerations as well as from wear and tear, and often cause a sudden loss of function in individual fingers or the thumb. Complete tendon lacerations generally require surgical reconstruction. Specialized hand therapy following surgery supports the healing process and helps prevent tendon adhesions from forming. It often takes several months before full load-bearing capacity is restored.