At a glance
Tendon repair is a surgical procedure that reconnects a torn or cut tendon, restoring the link between muscle and bone so that the affected body part can move again.
Tendons are tough, cord-like bands of tissue that transmit the pulling force of a muscle to a bone. When a tendon is partially or fully torn, that force can no longer travel across the injury, and the finger, hand, wrist, or other limb loses some or all of its movement. During surgery, the surgeon brings the torn ends back together and stitches them with strong sutures (surgical thread) designed to hold under the repeated stress of movement. In complex cases, a tendon graft (a piece of tendon taken from another part of the body) may be used to bridge a gap that is too wide to close directly.
Medical Condition
Tendon repair is used when a tendon has been damaged severely enough that normal movement cannot return without surgery. The injury may be sudden, such as a cut or sports accident, or may follow a long period of degeneration (gradual tissue breakdown).
- Complete or near-complete tendon rupture (full tear) caused by a sharp cut, such as a laceration (deep cut) from glass or a knife
- Avulsion injury, where the tendon pulls away from the bone along with a fragment of bone
- Closed rupture from sudden forceful movement, for example a mallet finger deformity (where the fingertip droops and cannot be straightened)
- Tendon damage from crush injuries to the hand or wrist
- Rheumatoid arthritis (an autoimmune joint disease) that has eroded and ruptured a tendon
- Failed conservative treatment, where splinting and physiotherapy have not restored adequate function
Surgery is not always the first choice. Doctors usually consider non-surgical approaches when the tendon is only partially torn, when the patient's general health makes anaesthesia (medication that blocks pain and consciousness) too risky, or when the patient is unlikely to follow the intensive rehabilitation required after repair.
- Partial tears where less than half the tendon width is involved and strength is preserved
- Patients with severe uncontrolled medical conditions that raise the surgical risk unacceptably
- Very elderly patients or those with low physical demands, for whom splinting alone may give acceptable function
- Injuries where the tendon has been without blood supply for so long that tissue viability (ability of the tissue to survive) is in doubt
Risks & Complications
Tendon repair is generally safe, but like any surgery it carries risks, and some complications are specific to the tendons of the hand and wrist.
- Adhesion formation: scar tissue (fibrous bands) can bind the repaired tendon to surrounding structures, limiting gliding movement
- Re-rupture: the repaired tendon tears again, most often during early rehabilitation if too much force is applied
- Infection at the wound site, which may require antibiotics or further surgery
- Stiffness of the adjacent joints if early movement is delayed
- Nerve or blood vessel injury near the repair site, which may affect sensation or circulation in the finger or hand
- Bowstringing: the tendon no longer stays close to the bone and pulls away in a straight line, reducing power and control
- Incomplete recovery of movement or strength, even after successful repair and rehabilitation
- Anaesthesia-related reactions, such as nausea or, rarely, allergic responses
Preparation & Procedure
Preparation starts before the day of surgery and covers what you eat, any medicines you take, and your lifestyle habits.
Your surgical team will usually ask you to stop eating solid food at least six hours before surgery and to stop drinking clear fluids at least two hours before, though exact times depend on the type of anaesthesia planned. Blood thinners, anti-inflammatory medicines, and some supplements are typically paused in advance because they increase bleeding risk. Smoking slows tendon healing, so stopping or reducing smoking before surgery is advised. Alcohol is usually avoided in the days before the procedure.
Several tests are commonly run beforehand to make sure surgery is safe. These may include blood tests to check clotting and general health, imaging such as an ultrasound (USG) or MRI to map the exact location and extent of the tendon injury, and an X-ray if a bone avulsion is suspected. Your surgeon will also review your hand function and skin condition around the injury site.
On the day of surgery, the procedure typically follows these steps.
- You are given anaesthesia, which may be local (numbing only the hand or arm), regional (a nerve block that numbs the limb), or general (full sleep), depending on the injury and surgeon's preference.
- A tourniquet (a cuff that temporarily reduces blood flow) is applied to the upper arm or forearm so the surgeon can see the tendon clearly in a bloodless field.
- The surgeon makes one or more incisions (cuts) over the injured area to expose the tendon.
- The torn ends are located and, if they have retracted (pulled away), retrieved with fine instruments.
- The ends are joined using a specific suture technique chosen for the tendon's location and the amount of tension it will face.
- In some cases, a tendon graft is harvested and stitched in to fill a gap.
- The outer layer of the tendon sheath (the protective sleeve around the tendon) is repaired where possible to support gliding.
- The wound is closed in layers, and a splint or padded dressing is applied to protect the repair.
Aftercare
Recovery after tendon repair is a gradual process that depends heavily on the location of the injury, how long the tendon was damaged before surgery, and how well rehabilitation is followed. Most patients go home the same day or the following day, but the rehabilitation phase lasts many weeks.
- The hand or wrist is kept in a protective splint or cast for a period directed by your surgeon, usually several weeks, to prevent stress on the new repair.
- Controlled early movement, guided by a hand therapist (a specialist in hand rehabilitation), often begins within days of surgery to reduce adhesion formation and joint stiffness.
- The wound is kept clean and dry until the surgeon confirms healing; dressing changes follow the schedule the surgical team provides.
- Any swelling is managed by keeping the hand elevated (raised above heart level) as much as possible, especially in the first week.
- Stitches or staples are removed at a follow-up appointment, usually within one to two weeks.
- Pain is typically managed with prescribed oral medicines; ice packs over the dressing can also help reduce swelling.
- Gripping, lifting, and heavy use of the hand are restricted until the tendon has regained sufficient strength, which your therapist assesses progressively.
- Driving, returning to work, and resuming sport are all guided by individual progress; timelines vary considerably between patients.
- Follow-up appointments allow the surgeon and therapist to track tendon gliding, joint range of motion, and grip strength over the weeks and months after surgery.
- Smoking slows tendon healing; patients are usually counselled to avoid it throughout the recovery period.
Cost & What Determines It
The cost of tendon repair varies widely because no two cases are alike. A single clean laceration repaired under local anaesthesia in a day-surgery setting is very different from a complex reconstruction involving multiple tendons, a graft, and several nights in hospital.
- Injury complexity: the number of tendons involved, whether the injury is in the flexor (bending) or extensor (straightening) system, and whether a graft is needed all affect operating time and cost.
- Location of the tear: injuries within certain zones of the hand require more technically demanding repairs and longer theatre time.
- Hospital class and country: a public hospital in one country may price the procedure very differently from a private specialist centre or an internationally accredited hospital in another.
- Type of anaesthesia used: local, regional nerve block, or general anaesthesia carry different fees.
- Length of stay: day surgery, overnight, or multi-day admission each carries a different room and nursing cost.
- Specialist fees: a hand and microsurgery specialist typically commands a different fee than a general surgeon.
- Rehabilitation and hand therapy: sessions with a hand therapist, custom-made splints, and any therapy equipment are usually separate from the surgical fee.
- Imaging before and after surgery: MRI, ultrasound, or X-rays needed to plan or confirm the repair.
- Implants or fixation devices: if bone anchors or other hardware are used to reattach the tendon to bone, these add to the cost.
- Post-operative medications: antibiotics, pain relief, and any medicines taken during recovery.
Hospital packages for tendon repair typically bundle the surgical fee, operating theatre time, anaesthesia, one or a set number of inpatient nights, standard dressings, and basic post-operative review into one quoted price. Items that are often billed separately include advanced imaging, specialist hand therapy sessions, custom splints, take-home medications, and any return to theatre if a complication arises.
Indonesian patients travelling abroad for this procedure should know that BPJS Kesehatan does not cover treatment received outside Indonesia, and most domestic private insurance policies do not either. This means the full cost is usually paid out of pocket, unless the patient holds a private international health insurance plan that explicitly covers overseas surgery. Requesting a written, itemised cost estimate from the hospital before booking travel is the most reliable way to understand the full financial commitment and avoid unexpected bills on arrival.
Frequently Asked Questions
How long does tendon repair surgery take?
Most tendon repair operations take between one and three hours, depending on how many tendons are involved and how complex the injury is. A clean cut to a single tendon is usually quicker to fix than a torn or badly damaged one. Your surgeon will give you a clearer time estimate once they have reviewed your scans and wound.
Will I be awake during the operation, and how much will it hurt afterwards?
Most tendon repairs are done under regional anaesthesia, meaning only the arm or hand is numbed, so you are awake but feel nothing in the area being operated on. General anaesthesia, where you are fully asleep, is also used in some cases, and your anaesthetist will discuss which option suits you. After surgery, the area will be tender for several days, but doctors typically manage this with oral pain relief and keeping the hand elevated.
How long is recovery after tendon repair, and when can I go back to work?
Recovery after tendon repair usually takes between three and six months before full strength returns, though this varies with the tendon repaired and how well rehabilitation goes. Most people can return to light desk work within a few weeks if the operated hand is not needed heavily, while jobs requiring gripping or lifting take longer. A hand therapist will guide you through a structured exercise programme to protect the repair while helping the tendon regain movement.
How much does tendon repair surgery cost?
The cost depends on several factors specific to your case, including the number and location of tendons repaired, the complexity of the injury, the length of your hospital stay, and the class of hospital you choose. Microsurgery techniques used in hand and finger tendon repairs can also affect the overall fee. Requesting a written estimate directly from the hospital is the most reliable way to get a figure that reflects your situation.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
