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Procedures

Extensor Tendon Repair

General Information

Extensor tendons allow you to stretch the fingers and thumb outward. These tendons are found on the backside of the fingers and hand. Tendons attach to the muscles, and help you move your fingers and hands in any range of motion. Injuries to the tendon are caused by a variety of reasons, and tears or cuts in the tendon require surgery to re-attach.

Reason for Extensor Tendon Repair

Since the extensor tendons are close to the surface, even a minor injury or cut to the back of the hand or finger can cause the tendon to split. Jammed fingers are also another cause for tendon injuries, as a displaced bone can cause a tear in the tendon where it meets the bone. Other reasons for tendon repair include injuries caused by:

  • Blunt force trauma to the hand
  • Lacerations
  • Burns
  • Animal bites

Diagnosis

After an extensor tendon injury, there are a few indications a hand surgeon will look for. Minor tears can be repaired in an emergency room, though a hand surgeon is often recommended. A skilled hand surgeon should repair extreme injuries, such as bone displacement and open space over the joints. Other indications a repair should take place include:

  • The tendon laceration is more than 50-percent
  • Tendon laceration has less than 50-percent injury, but there is limited strength in the hand or finger
  • Joint opening, skin loss or bone fracture associated with a tendon laceration

Surgery

To repair a tendon, the following steps are necessary:

  • Local anesthetic is used to numb the area for repair or exploration of the wound
  • Elevate the hand to allow to encourage blood draining from the hand through gravity
  • Sutures are used to attach the tendons back together
  • Sutures are then used to attach the skin edges back together after the repair
  • Hand or finger is placed into a splint and taped to restrict movement during the healing process

What to Expect

As the injury heals after surgery, there may be scarring left behind on the tendon. Scarring can reduce mobility of the tendon, and in extreme cases, may prevent the finger or hand from fully stretching. Your doctor may suggest physical hand therapy to increase movement in the hand or finger after it has fully healed.