To evaluate the role of musculoskeletal ultrasound in the early postoperative period following hand tendon repair. By assessing its diagnostic accuracy and clinical utility, the study seeks to determine whether routine MSK-US surveillance can contribute to earlier detection of complications, guide timely management decisions, and ultimately improve functional outcomes in patients undergoing hand tendon surgery.

Hand tendon injuries are among the most frequent traumatic lesions of the upper extremity, representing a major cause of emergency and elective surgeries. Despite advances in surgical techniques, these injuries remain challenging due to the risk of postoperative complications such as rupture, adhesions, infection, and impaired tendon gliding. Early recognition of such complications is essential to prevent long-term stiffness, disability, and functional loss .

Postoperative assessment traditionally relies on clinical examination, but this may be limited by pain, swelling, dressings, or poor patient compliance, and subtle complications may not be evident until significant dysfunction develops. Hence, there is a need for a reliable, non-invasive modality to aid early detection and guide timely intervention.

Musculoskeletal ultrasound (MSK-US) has become an important tool for evaluating tendon injuries. It offers high spatial resolution, dynamic real-time imaging, absence of ionizing radiation, cost-effectiveness, and broad availability. In postoperative settings, MSK-US provides valuable information on tendon continuity, vascularity, surrounding soft tissue changes, and the presence of adhesions or fluid collections. Its ability to assess tendon motion dynamically further enhances its role in monitoring functional recovery.

Evidence indicates that MSK-US can detect complications such as rerupture, adhesions, or infection earlier than clinical examination, supporting its role as an adjunctive modality in follow-up. However, standardized use of ultrasound in routine postoperative surveillance of repaired hand tendons has not yet been established.

Inclusion Criteria: adults with primary hand tendon repair and able to return for US follow-up.

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Exclusion Criteria: Patients with collagen disease, congenital hand deformities, bone fractures, revision/staged repairs, active infection/poor wound access, or can't attend follow-up.

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Patients who undergone hand tendon repair after trauma