Extensor Tendon Injury

Extensor tendon injuries affect the tendons that allow you to straighten your fingers and thumb. These tendons run along the back of the hand and fingers and are essential for opening the hand and controlling movement.

Injury can occur following a cut to the back of the hand or fingers, or as a result of forceful impact or trauma. Because these tendons lie close to the skin, they are more vulnerable to injury.

An extensor tendon injury may result in difficulty or inability to fully straighten the affected finger or thumb. Early assessment is important to restore movement and function.

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Diagnosis is based on clinical assessment, including examination of finger movement and tendon function.

The inability to fully straighten a finger or thumb is a key finding.

Imaging may be used in more complex cases to assess the extent of injury or associated damage.

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Treatment depends on the type and severity of the injury.

Non-surgical treatment may include:

• Splinting to protect the tendon and allow healing
• Activity modification during recovery

In many cases, particularly where the tendon is completely divided, surgical repair may be required, followed by a structured rehabilitation programme.

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When surgical repair is required, the tendon is rejoined using specialised techniques.

The procedure is typically performed under local, regional or general anaesthetic. The aim is to restore tendon continuity and allow normal movement to return.

Following repair, the tendon must be protected while it heals.

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Recovery following extensor tendon injury depends on the type of injury and treatment performed.

Recovery typically involves:

• Use of a splint to protect the repair
• Controlled movement guided by hand therapy
• Gradual return to activity over time

Recovery timelines vary, but most patients regain good function with appropriate rehabilitation.

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As with any surgical procedure, there are potential risks, although these are uncommon.

Possible complications include:

• Infection (around 1%), usually treated with antibiotics
• Swelling or stiffness, which may take time to settle
• Scar sensitivity
• Nerve irritation or injury (rare)
• Ongoing pain or discomfort, which typically improves over time
• Recurrence of symptoms (uncommon)
• Residual symptoms, particularly if the condition was advanced before treatment
• Tendon rupture or incomplete healing
• Reduced range of movement

Very rarely, a condition known as complex regional pain syndrome (CRPS) can occur, leading to prolonged pain and sensitivity.

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You should seek medical advice if you are unable to straighten a finger or thumb following an injury, particularly if there is a cut to the hand.

Early assessment is important to guide treatment and optimise recovery.

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