Medical advice please

I only know about snapped Achilles tendons which I guess are a bit similar but may also be different.

I opted for just letting mine grow back and it's now about 80 or 90% of where it was. Just put the two ends as close together as possible.

There's quite a lot of research which, as far as I could tell, mostly suggested it made very little difference one way or the other. The older you are the less benefit there is to having an op as you recover slower anyway.

I wonder if he might be better served talking to some rehab physiotherapists - it sounds like they would be involved in either situation, and may help to provide an more "outcome focused" discussion than a surgeon

Odd that the surgeon won’t suggest a preferred option

Maybe they should ask for a 2nd opinion from a different surgeon ie try and get referred to a main specialist 

A physio is NOT the person to ask. 

Tell him to take pain killers, he'll become an aspirin' painter

Thoughts, insight and a joke. The holy trinity!

A complicating factor is that apparently any operation has to be undertaken within the next couple of weeks, otherwise the tendons will atrophy so much that it becomes difficult to join them back together. This happened to my father when he had a fall and hurt his knee. Somehow snapped ligaments were missed and it was only when we realised that he could effectively bend his knee the wrong way that it was looked at again. By then it had been a couple of months and best they could do was a botched job..

Is there a time within which any surgery would have to be done? If not, I'd leave it and fix it later if it turns out to be a problem. My general instinct is that if surgery and non-surgery are 50/50, avoid surgery.

A friend of mine at work had this.... He snapped the tendon whilst at the gym. I don't know accurate details I'm afraid, but I know he had the repair operation. There was a fairly lengthy recuperation, and he's got no loss of movement as a result. But he now avoids anything very strenuous and doesn't push himself as hard at the gym etc, there's a definite fear of it happening again! 

I did the exact same thing as your pal a couple of years back. The key thing is - whatever decision you make, make it quickly. The chances of a successful outcome from the surgery diminish rapidly over time.

I snapped the tendon on a Saturday afternoon, was under the knife the following friday morning. Allow 3 or 4 weeks to pass and the decision will have been made for you as you can't really do the surgery successfully any more, your body starts re-absorbing the damaged tendon and theres nothing to attach.

For your pal - I guess the question is how important is strength in the arm for what you do day to day (and into the future) - for me it's quite important. If I'd been nearer to retirement I'd maybe not have bothered.

Thats the long term consideration.

The short term consideration is recuperation from the surgery is more disabling than the injury itself. Depending on the method used you're looking at 3-9 months recovery, as in before you can put a full load on that arm -  in the early stages being unable to use the arm at all. I couldn't even type for several weeks let alone drive.

So if he's self employed he has to think about that impact short term.

It also requires committed physio therapy - losing wrist mobility and so on - thats what comes of not adhering to the regime. What happens is any broken bits of tendon need to be trimmed and a new attachment to the bone made - for me that was drilling a hole in my forearm - threading the tendon through and sort of tying it a knot. The result of that is the muscle as a whole ends up shortened and that effects the mechanics of your whole arm from your shoulder blade to your finger tips really (hold your bicep and turn your hand from palm up to palm down - see how it needs to be fully relaxed/extended for your hand to face down, you can't do that when the tendon is shortened) - thats why I couldn't type.

So theres a lot of work to do to gradually stretch out that muscle, in tiny increments, without straining the repair too much. And you have to do it, nobody can do it for you.

For me I got the stronger but more invasive 'drill a hole' surgery, which was more painful in the short term, required more committment to physio but got me to a load-bearing level of recovery in a shorter time frame. At 3 months I was able to have it take weight again (although I'd lost a fair bit of strength in that time) and had the full range of wrist mobility back. After a year or so the surgery was completely forgotten about.

I suffered a little nerve damage (the surgery site is very close to the nerve that runs down inside of your elbow) that manifested in numbness of the skin on the side/back of my forearm but that resolved itself over a few months

I snapped a tendon in my bicep after surgery on a dislocated shoulder twenty years ago and have a popeye bicep. Happened when I was young, fit and active but i'd been given a fairly pessimistic prognosis for the shoulder surgery anyway so didnt bother with more surgery. It transpired that it hasn't made much difference, I haven't experienced and issues with my wrist and only feel any weakness / ache in the arm (right) during extreme exertion. I did do a lot of physio on the shoulder and was quite focussed on my recovery.

Thanks all, this is great advice and insight. I'd forgotten to mention tye recuperation aspect. As a painter and decorator, even though he uses the other hand, his right is still necessary from time to time. That being the case, and with what seems the relative 50/50 of the two options, I'd have thought that do nothing makes more sense.