Extensor Tendon Injury

 

What are Extensor Tendons?

The extensor tendons are strong bands of tissue that straighten the fingers by connecting the muscles of the forearm and hand to the bones in the fingers and thumb. The extensor tendons are directly under the skin and are easily injured by any cut across the back of the wrist hand or fingers. The tendons can also be injured by jamming the end of the finger, which may cause the tendons to dislodge or rip from their attachment to the bones.

What may indicate I have an extensor tendon injury?

Usually an extensor tendon injury starts with some type of trauma – either a cut to the back of the hand or jamming the finger. If you have difficulty straightening your fingers or thumb, if the finger is held in a downwards bent position, or if you have pain when trying to straighten your finger, you may have an extensor tendon injury

 How will an extensor tendon injury be diagnosed?

The diagnosis of an extensor tendon injury is generally made on physical examination. Our hand surgery specialist will perform numerous physical exam maneuvers, and combined with the story of your injury, will determine if they suspect an extensor tendon injury. Additional tests, such as x-rays or ultrasound may be ordered to help diagnose the injury.

If I have an injury, what will be the treatment?

Generally speaking, the treatment will be guided by the nature of the injury. Some extensor tendons can be treated with splinting and hand therapy alone. However, most cut tendons will require some form of tendon repair – this is done surgically. Our hand surgery specialist will explain the type of injury you have, and inform you of what type of repair needs to be done.

Extensor tendon repair can be done under local anesthetic, regional anesthetic (your arm will be put to sleep but you will not require general anesthesia), or general anesthesia. During surgery, the injured extensor tendons will be meticulously dissected and stitches will be placed to repair the lacerated tendon. At the end of the operation, your arm will be placed in a splint or cast.

Our hand surgery team specializes in the techniques of “awake tendon repair” for extensor tendon injuries. This technique allows our hand surgeon to test the repair while in the operating room, ensuring that the tendon repair is strong and able to undergo intense physical therapy. This leads to decreased scar tissue, earlier return to function, and has demonstrated superior outcomes than traditional repair performed under general anesthesia. Our hand surgery specialist will discuss this with you further during your consultation.

Will I need therapy?

Our specialists believe the successful outcome of any tendon repair is 50% related to how well it is surgically repaired, and 50% how well patients perform therapy. The therapy program after tendon repair is crucial and at least as important as the operation itself, so it is vital to follow the instructions of the therapist closely. The objective is to keep the tendon moving gently to prevent it from sticking to the surrounding tissues but to avoid breaking the repair.  For the most part, therapy will start 3-5 days after your operation.

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