Extensor Tendon Injuries
Use 3-0 and 4-0 nonabsorbable braided sutures for extensor tendons of the hand and fingers, respectively. Use a figure-of-8 technique for suturing extensor tendon lacerations in the ED - Daniel Ting MD, Jared Baylis MD and Jordan Haythornthwaite MD
HWN Suggests
Extensor tendon injuries of the hand: Emergency Department management
Extensor tendon injuries fall into 2 general categories: open versus closed. Both rely on a high index of suspicion and careful physical examination. Closed injuries only require splinting in a volar extension splint with a hand surgery follow-up within 1 week. Some open injuries can be repaired in the ED, and some will need delayed repair by a hand surgeon. Ultimately, all these injuries (repaired or not) need hand surgeon follow up in one week.
Featured
Open Extensor Tendon Repair in the ED
Do not perform ED repair for lacerations in zone III (over the PIP) or at/proximal to the wrist
Articles of Interest
Emergency Department Management of Extensor Tendon Lacerations
For open injuries, hand surgeons use another classification method where zone I is split up into four different types.2 For our purposes, we will focus on open injuries with an associated tendon injury that you have identified on exam.
Tendon injuries of the hand
Blunt disrupters of the extensor tendons of the DIP (“mallet finger”) (Verdan Zone 1[7]) can be treated conservatively using a stack splint if the injury is just a partial rupture in which the collateral fibers of the “Landsmeer ligaments” (lig. retinaculare obliquum) are intact.
