Extensor Tendon

Abstract

The extensor tendon injuries in thumb more frequently occur than flexor tendon. The composite system of extensor mechanism with extensor retinacula structures and both extrinsic and intrinsic tendon may contribute to the difficult management. Thus, a thorough understanding of the anatomy and extensor mechanism is necessary to provide appropriate treatment. The diagnosis of extensor tendon injuries is often evident. But, open lesions should be surgically explored to identify the extent of the injury and prevent secondary ruptures. Various types of incisions can be used for open repair based on surgeon’s preference and the shape of the previous laceration. The strength of tendon suture is affected by the number of suture strands passing through the repair site, the suture diameter, the suture material properties, and the suture method. In case of segmental degeneration, it must be reconstructed. The transfer of extensor indicis proprius or tendon graft using the palmaris longus tendon is the most widely used for reconstructing the EPL. In complicated injury, radical debridement of all contaminated and devitalized tissue is mandatory and osseous structures and tendons must be provided with durable and healthy soft tissue coverage. Thus primary or delay flap surgery is often necessary.