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Dr. Mark
Dr. Mark, Doctor (MD)
Category: Health
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Experience:  U.S. Physician/Surgeon in Neurosurgery
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My daughter has a possible torn tendon in her right hand.

Resolved Question:

My daughter has a possible torn tendon in her right hand. The x-rays are negative, but she cannot raise her middle finger on her own and is bruised. We saw an orthopedic surgeon today and he wants to do surgery tomorrow. Even though he can't see anything, he presumes a tendon is torn and the longer she waits, the more likely it is it cannot be repaired. If you agree with the doctor, what do you think the estimated cost will be at a surgical center in Pinellas County, Florida? My deductible is 5K. Should we try an alternative treatment, and if we do, do we run the risk of permanent damage?
Submitted: 5 years ago.
Category: Health
Expert:  Dr. Mark replied 5 years ago.
Did she injure this hand in any way? How long ago?
Customer: replied 5 years ago.
Yes, she hit her fist against a window on New Year's Eve.
Expert:  Dr. Mark replied 5 years ago.
OK.

It's possible then that she tore the tendon off of the bone of her finger - and usually if surgery is indicated (as it appears it is), it usually is done within 4-6 weeks after the injury (for the best chance at repair).

Some injuries of "extensor tendons", such as a partial tear can be treated with a splint, but I'm guessing the surgeon feels that this was a complete injury, based on the physical exam.

Unfortunately, it is impossible for me to even guess at what an estimated cost at a surgical center would be since I can only estimate the surgeon's fee. (The surgery center will have it's own fees, such as for equiptment, Operating room time, nursing, anesthesia, etc...). The surgeon's fee for such a surgery would likely be in the range of $800-1200 itself. The best way to figure a total cost is to call the practice's office manager today for an estimate.
Customer: replied 5 years ago.
I appreciate your response. I guess the only alternative would be a splint, but then if that does not work, time will not be on her side.

I just wish the surgeon could see the damage, so I know we are doing the right thing, since this will be very costly for me. He said an MRI will not show anything.

The last question, then, is: Is there any way to see the damage short of surgery? And I'm assuming a splint will not repair a torn tendon. And what is the likelihood of success in this type of procedure?

Expert:  Dr. Mark replied 5 years ago.
Because of the small nature of the tendon - it is very hard, if not impossible to see.

Xrays ruled out dislocations/fractures, but cannot see tendons.
The resolution of a MRI is not good enough to determine a tendon rupture in the hand.

So it is based on the clinical exam itself.

The likelihood of success, unfortunately, depends on the nature of the problem. If it is a torn tendon, the surgeon can repair it by reattaching it to the bone, and with time, this should heal. If for some reason, it is something else, then it is hard to predict.
Dr. Mark, Doctor (MD)
Category: Health
Satisfied Customers: 11946
Experience: U.S. Physician/Surgeon in Neurosurgery
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