EXTENSOR TENDON LACERATIONS

Question 1

Referal criteria for Plastics

Answer 1

Extensor tendon injury of the thumb
Severe contamination

Question 2

Acute Management

Answer 2

Extensor tendon injuries between distal wrist and MCP joints
Z pattern incision
3-0 absorbable suture (PDS Suture)
Figure of 8 stitch with knot placed at edge of tendon
Volar Splint wrist 30 degree extension, MCP, PIP, DIP full extension
Follow up with plastics in 7 days

Question 3

Complications

Answer 3

Mallet finger
Swan neck deformity
Boutonniere deformity

Question 4

Post repair management

Answer 4

Cast / Splint for 3 weeks
Removable splint 3 weeks (reading, writing, arithmetic)
Light strengthening / protected activity for 6 weeks
NO SPORTS / HEAVY LIFTING FOR 3 months total