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Extensor Tendon Surgery

http://www.handandwristinstitute.com/... - The tendons that start in the forearm and extend across the hand into the finger and allow for extension of the digits are called extensor tendons. Because they are so close to the skin, and such long structures, they are very prone to injury anywhere along their path of travel. Like the flexor tendons, they anchor on the PIP and DIP joints separately, and these anchorage sites are primarily where they are injured through trauma. Boutonniere deformity occurs when the tendon is torn away from its anchor at the PIP joint, causing it to drop noticeably, paired with hyperextension in the DIP joint. A special brace, called a PIP extension brace, is used to hold your finger in place for six to eight weeks, allowing the tendon to knit itself back to the bone and regain function. It is important to note that the splint must be worn constantly, and if it is removed for any reason, the entire time frame must be restarted. Mallet finger is another common extensor tendon injury, and it is the same mechanism as boutonniere finger, but it occurs to the DIP joint. The tendon is torn from the bone and the tip of the finger drops down in immediate flexion. Again, a custom designed splint called a STACK splint is utilized to treat this injury. It holds the joint in a slightly hyperextended position, bringing the tendon and the bone together and promoting healing. As with the other splint, it must be worn constantly, and any removal with completely render useless the previous time spent in it. Lacerations of the extensor tendon require surgical intervention to fix. They are sewn together as with flexor tendon injuries, using sutures that hold the tendon together and allow it to grow back together. The sutures must be strong enough to hold the tendon, but delicate enough not to impeded motion in the tendon sheathes and pulleys. After injury to the tendon, splinting can be extensive and often other special splints are required to help develop range of motion. Twelve weeks is the general recovery time for injuries of this nature.