Microsurgical repair to bring back movement, sensation and blood supply.
Nerve, tendon and vascular repair restores movement, sensation and blood supply after injury to the hand or arm. Tendons restore movement, nerves restore feeling, and vessels keep the tissue alive. Repair is best done early, and hand therapy afterwards decides the final outcome.
A cut across the wrist or hand can divide all three at once, and each behaves differently afterwards. Tendons, once repaired, work almost immediately but will stick down with scar if not moved correctly in the first weeks.
Nerves are slower. A repaired nerve regrows at roughly one millimetre a day, so recovery of sensation in the fingertips after a wrist level injury takes many months. Vessels either work at once or they do not, which is why any suspicion of poor circulation is an emergency.
Tendons retract when cut, and after a few weeks the ends shorten and scar, making direct repair difficult or impossible. What could have been a straightforward repair in the first days becomes a tendon graft or transfer later, with a poorer result.
Nerves behave similarly. Early repair, with clean ends brought together without tension, gives the best chance of useful recovery. Where a gap exists, a nerve graft is used, and the result is generally less good than direct repair. So a hand injury that seems to have healed but has lost movement or feeling should be assessed sooner rather than later.
This is the part patients underestimate. A technically perfect tendon repair that is immobilised for six weeks produces a stiff finger that does not bend. Controlled movement under a hand therapist's supervision, starting within days, is what prevents that.
Splints are used to protect the repair while allowing the specific movements that keep tendons gliding. The programme changes week by week. Patients who follow it do well. Patients who do not, whatever the quality of the surgery, generally end up with a stiff hand.
| Factor | What it covers |
|---|---|
| Structures involved | Tendon, nerve and vessel repair each add operative time |
| Number of structures | Multiple tendons or nerves lengthen the procedure |
| Grafting needed | A nerve or tendon graft adds a donor site and time |
| Anaesthesia | Regional block or general anaesthesia |
| Hand therapy | A structured programme over three to six months |
These pages answer the questions that most often come up alongside this one.
It depends on how many structures are involved and whether grafting is needed. Hand therapy afterwards is a separate ongoing cost and should be budgeted for, since it is essential rather than optional. An estimate covering both is given after assessment.
A repaired nerve regrows at roughly one millimetre a day. For a wrist level injury that means many months before sensation reaches the fingertips. Progress can often be tracked as a tingling sensation that moves gradually down the finger.
Often close to it after clean, early repair with good therapy. Crush injuries, delayed repair and injuries needing grafts generally recover less completely. An honest assessment is given once the injury has been examined.
Many repairs are day-care, particularly isolated tendon injuries. More complex injuries involving vessels or multiple structures may need a short admission.
Because a repaired tendon that is not moved correctly sticks down with scar and stops gliding. Surgery restores the anatomy, therapy restores the function. Skipping it is the commonest cause of a stiff hand after technically successful surgery.
Usually three to six months, with the intensity reducing over time. The first six weeks are the most critical and the most demanding.
Not necessarily, but the options change. Late reconstruction may need tendon transfer or nerve grafting rather than direct repair, and the result is generally less good. It is still worth assessment, since useful function can often be restored.
Repair after trauma is frequently covered. Hand therapy may be covered in part or may fall outside the policy, so it is worth checking specifically, since it forms a significant part of the overall treatment.
Published with written patient consent and shown for education rather than promotion. Every case is different and these images are not a promise of results.
Consultations at Kiran Hospital, Katargam, Surat. Outstation and NRI patients can request a video consultation before travelling.