Extensor tendon injuries: Acute management and secondary reconstruction

Kevin R. Hanz, Michel Saint-Cyr, Maynard J. Semmler, Rod J. Rohrich

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

LEARNING OBJECTIVES: After reviewing the article, the participant should be able to: (1) Describe the anatomy of the extensor tendons at the level of the forearm, wrist, hand, and fingers. (2) Recognize variations in the anatomy. (3) Master the hand examination and define the relevant findings in acute injuries of the extensor tendon(s). (4) Delineate the techniques for extensor repair in both acute and secondary (delayed) management. SUMMARY: Extension of the fingers is an intricate process that reflects the combined action of two independent systems. The interossei and lumbricals constitute the intrinsic musculature of the hand. These muscles innervated by the median and ulnar nerves extend the proximal interphalangeal and distal interphalangeal joints and flex the metacarpophalangeal joints. The extrinsic extensors are a group of muscles innervated by the radial nerve, originating proximal to the forearm. The extrinsic digital extensor muscles include the extensor digitorum communis, extensor indicis proprius, and extensor digiti quinti. The digital extensors function primarily to extend the metacarpophalangeal joints, but also extend the proximal interphalangeal and distal interphalangeal joints. Normal extensor physiology reflects a delicate balance between these two unique extensor systems. In the injured hand, a functioning intrinsic system may potentially compensate for an extrinsic deficit. An understanding of the relevant anatomy and an appreciation for the complex interplay involved in extensor physiology is necessary to recognize and manage these injuries.

Original languageEnglish (US)
JournalPlastic and Reconstructive Surgery
Volume121
Issue number3
DOIs
StatePublished - Mar 2008

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Tendon Injuries
Hand
Metacarpophalangeal Joint
Anatomy
Forearm
Muscles
Fingers
Joints
Radial Nerve
Ulnar Nerve
Median Nerve
Wrist
Tendons
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery

Cite this

Extensor tendon injuries : Acute management and secondary reconstruction. / Hanz, Kevin R.; Saint-Cyr, Michel; Semmler, Maynard J.; Rohrich, Rod J.

In: Plastic and Reconstructive Surgery, Vol. 121, No. 3, 03.2008.

Research output: Contribution to journalArticle

Hanz, Kevin R. ; Saint-Cyr, Michel ; Semmler, Maynard J. ; Rohrich, Rod J. / Extensor tendon injuries : Acute management and secondary reconstruction. In: Plastic and Reconstructive Surgery. 2008 ; Vol. 121, No. 3.
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