Extensor Tendon Injuries –Repair, Reconstruction, and Rehabilitation-Extensor Tendon Injuries

Extensor Tendon Injuries

Pdf Summary

Extensor tendon injuries occur commonly and can lead to poor outcomes if not treated appropriately. While these injuries receive less attention in the literature compared to flexor tendon injuries, recent studies have examined this topic. The extensor tendons in the forearm can be divided into superficial and deep muscular components. The tendons travel through dorsal compartments in the wrist to reach the hand. The treatment of extensor tendon injuries depends on the specific zone of injury. In zone I injuries, also known as mallet finger, the terminal tendon at the distal interphalangeal (DIP) joint is injured and typically requires splinting. In zone II injuries, which occur at the middle phalanx, partial injuries can be treated non-surgically with splinting, while complete injuries may require surgical repair. Zone III injuries involve the central slip, and treatment includes splinting and possible surgery depending on the severity of the injury. Zone IV injuries, over the proximal phalanx, can be treated non-surgically if there is no loss of extension, or with primary repair if there is complete loss of extension. Zone V injuries occur over the metacarpophalangeal (MCP) joint and often require immobilization and splinting. Zone VI injuries in the metacarpals have a better prognosis and can be treated with core suture. Zone VII injuries involving the extensor retinaculum may require surgery if there is complete rupture. Zones VIII and IX injuries in the forearm are difficult to repair due to tissue quality, and often require multiple figure-of-eight stitches. Rehabilitation after surgery for extensor tendon injuries can vary, but recent studies have shown that early mobilization and active mobilization protocols lead to better outcomes compared to traditional static immobilization. More research is needed to determine optimal treatment algorithms and rehabilitation protocols for extensor tendon injuries.

Keywords

extensor tendon injuries

flexor tendon injuries

mallet finger

splinting

surgical repair

proximal phalanx

metacarpophalangeal joint

immobilization

core suture

rehabilitation protocols