Filed under Emergency Medicine. Extensor tendons are quite superficial, covered only by skin and a thin layer of fascia, and are thus highly susceptible to injury by commonly experienced trauma. Such injuries may result from lacerations, bites, or burns, but they may also be caused by closed injury with even seemingly superficial lacerations.
Extensor tendon injuries of the fingers, hand, and wrist are frequently seen in the emergency department. One recent study found These can mask an extensor tendon injury because an uninjured adjacent tendon may compensate for extensor movement.
Extensor tendon injuries are very common injuries, which inappropriately treated can cause severe lasting impairment for the patient. Assessment and management of flexor tendon injuries has been widely reviewed, unlike extensor injuries. It is clear from the literature that extensor tendon repair should be undertaken immediately but the exact approach depends on the extensor zone.
Figure 1. Extensor injury zones. The hand is an intricate structure that provides us with the dexterity needed for our everyday lives. Unfortunately, we see many patients in the emergency department who take this functionality for granted until they lose all or part of it.
Tendons are thin cords of connective tissue that anchor bone to muscle to produce movement. Extensor tendons begin in the forearm and run along back of the hand to the thumb and fingers. These tendons allow the fingers and thumb to straighten or extend.
Tendon lacerations are some of the most common injuries seen by hand surgeons, with extensor tendons being involved slightly more often than flexor tendons. Extensor tendon lacerations typically result from penetrating trauma to the dorsal surface of the forearm, wrist, palm, or digits that reaches the extensor tendon s. Falling into a mirror or window are common machanisms of injury that cause extensor tendon laceration.
Extensor tendons are just under the skin. They lie next to the bone on the back of the hands and fingers and straighten the wrist, fingers and thumb Figure 1. They can be injured by a minor cut or jamming a finger, which may cause the thin tendons to rip from their attachment to bone.
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This tendon straightens the end joint of the thumb and also helps pull the thumb in towards the index finger. In this area it is confined to a tight tunnel. See diagram.