Extensor Tendon Injuries - Orthopedic & Sports Medicine

Description

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. If not treated, it may be hard to straighten one or more joints.

Common Extensor Tendon Injuries

Mallet Finger refers to a drooping end-joint of a finger. This happens when an extensor tendon has been cut or torn from the bone (Figure 2). It is common when a ball or other object strikes the tip of the finger or thumb and forcibly bends it.
Boutonnière Deformity describes the bent-down (flexed) position of the middle joint of the finger. Boutonniere can happen from a cut or tear of the extensor tendon (Figure 3).
Cuts on the back of the hand can injure the extensor tendons. This can make it difficult to straighten your fingers.

Treatment

Tears caused by jamming injuries are usually treated with splints. Splints hold the tendon in place and should be worn at all times until the tendon is healed. The tendon may take eight to twelve weeks to heal completely. Longer periods of splinting are sometimes needed. Your doctor will apply the splint in the correct place and give you directions on how long to wear it.

Other treatment may include stitches (for cuts in the tendon). Also, a pin may need to be placed through the bone across the joint as an internal splint. Surgery to free scar tissue is sometimes helpful in cases of severe motion loss.

After treatment, hand therapy may be necessary to improve motion. Consult your hand specialist for the best form of treatment.

Figure 1 – Extensor tendons, located on the back of the hand and fingers, allow you to straighten your fingers and thumb

Figure 2 – The mallet finger deformity causes a droop of the fingertip. This is caused by injury to the extensor tendon at the last finger joint.

Figure 3 – The boutonniere deformity with progressive bending of the middle joint may result in a stiff finger in this position if not treated. The end joint also bends backward across the finger.

Orthopedic Sports Medicine Center of Oregon is located in Downtown Portland Oregon. Dr. Dominic Patillo, one of our Board-Certified Orthopedic Surgeons, specializes in hand surgery. His practice focuses on the treatment of both simple and complex hand and upper extremity conditions as well as general orthopaedic trauma. He is experienced with modern microsurgical techniques including nerve and vessel reconstruction.

Common problems treated include:

carpal tunnel syndrome
tennis elbow
wrist pain
sports injuries of the hand and wrist
fractures of the hand, wrist, and forearm
trigger finger

Other problems treated can include arthritis, nerve and tendon injuries, and congenital limb differences (birth defects).

If you have pain in your fingers, hand, wrist or arm, or if you have other upper-extremity related concerns, please consult our hand specialist Dr. Dominic Patillo for a consultation.