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Extensor Tendon Injuries (Hand)

Introduction

An extensor tendon injury occurs when the tendon is torn, cut or otherwise detached.  The extensor tendons attach to the back of your fingers and thumbs.  They allow your fingers and thumbs to straighten and perform fine coordinated movements.  Extensor tendon injuries can result from trauma, burns, or arthritis.

Extensor tendon injuries cause loss of movement, pain, and swelling.  Some extensor tendon injuries are treated with splinting and hand therapy.  Surgery may be necessary in cases of tendon separation, fracture, or malalignment.

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Anatomy

Your hand is composed of many bones that provide structure for your wrist and fingers.  Your fingers and thumbs are made up of bones called phalanges.  The bones are connected with strong ligament tissues.  Tendons are strong fibers that attach your muscles to your bones and allow movement.  Your hand also contains nerves, blood vessels, and fat.  The skin that covers your hand protects it from the environment.
 
Your extensor tendons begin in your forearm and continue to the back side of your fingers and thumb.  As the extensor tendons reach your fingers, they become flat and thin.  They are located just underneath the skin.  The extensor tendons are attached to your phalanges via a complex system.  The extensor tendons allow your fingers and thumbs to straighten and perform fine coordinated movements.  
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Causes

Arthritis, burns, and injuries, such as cuts or jammed fingers, can cause extensor tendon injury.  Boutonniere deformities and mallet finger injuries are specific types of extensor tendon injuries.  An extensor tendon may be partially or completely cut.  It can remain intact but pull a piece of bone away from where it attaches on the phalanx.  This is called an avulsion fracture.
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Symptoms

An extensor tendon injury can cause your finger or hand to feel painful and swollen.  It may be difficult or impossible for you to extend your finger. 
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Diagnosis

Your doctor can diagnose an extensor tendon injury by reviewing your medical history and examining your hand.  X-rays can identify an avulsion fracture or joint malalignment.

 
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Treatment

Many factors affect the seriousness of an extensor tendon injury such as associated fractures, infection, the degree of tendon separation, and if the tendon was cut or torn.  Treatment is individualized and your doctor will discuss your options with you.  Nonsurgical treatments for extensor tendon injuries include splinting and hand therapy.
 
Splinting positions your finger to allow the extensor tendon to heal.  It is important not to remove the finger splint at anytime, even while you shower.  If the finger splint is removed, even for the shortest amount of time, the treatment is disrupted and the process must start all over.  You will wear your splint for several weeks full-time, followed by a part-time splint schedule.  A dynamic splint may be used to allow movement while protecting the healing tendon.
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Surgery

Surgery is necessary for many extensor tendon injuries.  The ends of separated extensor tendons can be stitched together.  In rare cases, the extensor tendon may be tightened or repaired with a graft.
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Recovery

Splinting and surgical treatments are usually followed by hand therapy.  A hand therapist will show you exercises to stretch and strengthen your joints.  The other joints in your fingers may become stiff and benefit from hand therapy as well.  It can take an extensor tendon injury several months to recover from completely.  Healing is an individualized process.  Your doctor will let you know what to expect.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

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Dr. Reznick did major surgery on my right hand (carpal tunnel and 3 trigger fingers). Prior to the surgery, I could not hold a pen or write my name legibly. I was in constant pain. After the surgery, while the stitches were still in and the brace still in place, I had more flexibility in my fingers than I had before the surgery. I am six weeks out from the surgery and I continue to progress. I have more functionality and strength in my hand than I have had in the last year. I can't even see the scars on my hand. Dr. Reznick not only did a spectacular job of restoring the use of my hand, but she is a very likable person. Her staff is friendly and professional. I cannot say enough good things about this experience!

Nancy L.

via md.com

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Les D.

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Amazing visit. I can't remember the last time I spent quality time with a doctor. She explained everything to me on why I was having trigger finger issues. I have been dealing with this for some time. She nailed it on the first visit ‘cause she talks to you and listens! If you need a hand doctor you will be happy she is the one.

Anonymous

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Dr. Reznick is one of the most professional, sensitive and caring physicians I have visited. She is a teacher--patient and informative, and she made sure I understood just exactly what was necessary for my particular problems. She took care of both my left and right carpal tunnel surgeries, and I couldn't have asked for a better recovery. Everything went just as planned. She is my ‘go to’ hand doctor!

Anonymous

healthgrades.com

When I was having problems with my wrist, she guided me through every step, and always made sure I was comfortable with what she was doing. Very straightforward and trustworthy. I never doubted what she was doing and she always wants to try every technique before doing surgery to try to make you better.

Shannon C.

healthgrades.com

I recently rode 900 miles on a vibrating Harley-Davidson and did not have a single tingle in either of my hands. You do great work. Thanks for helping me.

Ed G.

Just wanted to let you know again how much I appreciated your care, expertise and skill in conducting the surgery on my hand. A job well done. Thank you.

Randall A.

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Kevin M.

Dr. Lisa Reznick has performed carpal tunnel surgery on both hands and has removed my basal joint from my right hand. All of my surgeries have been successful, and I now have complete use of both hands and my right thumb, which I credit to a great surgeon, good therapy, and a genuine concern for patients.

Robert

My hand is in perfect working order because of your expertise. I appreciate your genuine concern for my healing. Through the myriad of maladies my husband experienced, I became acquainted with many doctors. None even approached your level of patient care.

Trudy R.

Dr. Reznick performed surgery on my hand for ‘trigger finger’ and did a wonderful job. I’ll definitely user her again if the need ever presents itself again.

Don L.

Dr. Reznick is very to the point and no nonsense. She tells you what options there are in your treatment and advises you accordingly. I had hand surgery four years ago and it was a complete success. I actually went back to work one week early. I have recommended Dr. Reznick to many friends and associates. Frankly, I won’t go to anyone else when it comes to muscles or bones. I have complete faith in her.

J. Schully

via vitals.com

Dr. Reznick did major surgery on my right hand (carpal tunnel and 3 trigger fingers). Prior to the surgery, I could not hold a pen or write my name legibly. I was in constant pain. [Now] I have more functionality and strength in my hand than I have had in the last year. I can't even see the scars on my hand. Dr. Reznick not only did a spectacular job of restoring the use of my hand, but she is a very likable person. Her staff is friendly and professional. I cannot say enough good things about this experience!

~ Nancy L. via md.com

Lisa R. Reznick MD, PA

Board Certified Orthopedic and Hand Surgeon

4100 Fairway Court, Suite 120
Carrollton, TX 75010
Phone: (972) 395-9000
Fax: (972) 395-9002

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In Carrollton, TX, board-certified orthopedic surgeon Dr. Lisa Reznick offers conservative treatment options for all types of general orthopedic issues, while specializing in surgeries of the hand, wrist, and elbow.