Extensor tendon lacerations are serious injuries to tendons in the hand and fingers. These lacerations can occur as a result of trauma, such as a cut or stab wound, and can cause significant disruption to the extensor tendons of the hand and fingers. If left untreated, the injury can lead to permanent damage and disability. The correct treatment of an extensor tendon laceration is essential for optimal recovery and function and should be done as soon as possible.
Here, we will discuss the causes, diagnosis and treatment of extensor tendon lacerations in detail. We will also discuss the importance of seeking immediate medical attention to prevent further damage and reduce the risk of complications.
History and Definition
Extensor tendon laceration is a condition arising from the partial or complete rupture of extensor tendons, which are responsible for extending the joint. It is most commonly seen in the fingers, hands, wrists and forearms due to trauma.
First described by Hippocrates and Galen, tendon reconstruction was developed as a technique to repair these injuries. The goal of extensor tendon laceration repair is to restore function while maintaining good cosmetic outcomes. This is achieved by reattaching the torn ends of tissue and reinforcing them with sutures. To ensure successful healing, rehabilitation exercises must be performed regularly and range-of-motion activities should be done gently following surgery. With proper treatment and care, most patients can expect a full recovery within a few months.
While tendon laceration is a serious injury, with the right care and treatment it can be successfully managed. By taking the necessary steps to repair any damage and following a rehabilitation plan, individuals can regain full functionality in the affected area. With early diagnosis and prompt treatment, patients can make a full recovery from extensor tendon lacerations.
Symptoms
Extensor tendon lacerations can cause significant pain and disability due to the loss of function in the affected hand or finger. Common signs and symptoms related to a lacerated extensor tendon include:
- Pain: Severe burning or stinging pain at the site of injury that may be accompanied by swelling, bruising, and redness.
- Loss of Motion: Inability to actively extend the joint associated with the injured tendon. The affected digit may also appear bent or curled when placed against resistance.
- Numbness: Partial or complete numbness along the affected area as a result of nerve damage from the trauma.
- Deformity: Cuts in the tendon may cause the finger or thumb to bend unnaturally and remain in that position until treated.
- Weakness: Lack of strength when trying to actively extend the affected digit.
- Loss of Sensation: Loss of touch sensation along the top side of the finger, typically caused by damage to a nerve near a lacerated tendon.
- Instability: Inability to move or support an object due to lack of stability from an injured extensor tendon.
- Tenderness: Pain when pressure is applied to the area of injury or along the course of the tendon.
In some cases, extensor tendon lacerations may cause partial or complete amputation of a finger or thumb due to severe damage and loss of tissue. If you suspect that you have experienced an extensor tendon laceration, it is important to seek medical attention right away to prevent further complications.
Causes
Extensor tendon lacerations are common injuries and can occur in both adults and children. The most common causes of extensor tendon laceration include falls, crush injuries, sharp objects such as knives or glass shards, sporting accidents, animal bites, and car accidents.
- Falls: Falls are one of the leading causes of extensor tendon lacerations. This type of injury is especially common among elderly individuals due to age-related decreased mobility and vision problems that make falling more likely.
- Crush Injuries: Crush injuries can occur when a person’s limb is caught between two objects or trapped in a confined space. This type of injury can cause extensive damage to the extensor tendons, resulting in a laceration.
- Sharp Objects: Sharp objects such as knives and glass shards are also common causes of extensor tendon lacerations. Injuries from these items typically occur when someone is using them improperly or mishandling them in some way.
- Sporting Accidents: Extensor tendon lacerations can also occur during sports activities due to contact with another athlete’s body parts, hard surfaces, sharp objects, and other hazardous materials used in the sport.
- Animal Bites: Animal bites are another potential cause of extensor tendon lacerations. Dog and cat bites are the most common, as they can cause deep puncture wounds that can damage tendons in the affected area.
- Car Accidents: Finally, car accidents are a potential cause of extensor tendon lacerations due to the force of impact. Injuries sustained during a car accident can range from minor cuts and bruises to more severe injuries such as lacerations of tendons or other soft tissue.
In conclusion, extensor tendon lacerations can be caused by a variety of different incidents and activities. People should use caution to avoid these types of incidents to prevent potential serious damage.
Diagnosis
Diagnosis of an extensor tendon laceration is based on a patient’s history, physical examination, and imaging studies. The physical exam evaluates the damage to the tendon, including checking for active motor function, sensation in the area of injury, and range of motion. Imaging studies such as X-rays, MRIs, or ultrasounds may be used to assess the extent of the damage.
In some cases, an arthroscopy procedure may be performed to examine and repair any damage to the joint surfaces. Treatment options depend on the severity of the injury; these can include immobilization with a cast or splint for several weeks after which rehabilitation exercises are recommended.
Surgery will be necessary to suture or reattach torn tendons when the damage is severe. Once the tendon has healed, a physical therapy program to strengthen the muscles and improve flexibility in the joint should be started. Follow-up appointments with a physician or physical therapist can help ensure that correct healing progresses as expected.
Diagnosis of an extensor tendon laceration requires careful assessment and treatment; failure to properly treat a lacerated extensor tendon can lead to decreased function and pain. With prompt diagnosis and management, however, most patients make a full recovery from their injury.
Treatment
An extensor tendon laceration is a cut or tear in one of the tendons that run along the top of the hand and fingers, allowing them to straighten out. Treatment for an extensor tendon laceration typically involves surgical repair of the damaged tendon. The surgery is usually done under local or regional anesthesia and may involve sewing the tendon back together, or in some cases, using a graft to repair the tendon.
After the surgery, the hand and fingers will be immobilized in a splint or cast to allow the tendon to heal properly. Physical therapy will likely be recommended to regain the range of motion and strength in the affected hand and fingers. Recovery time can vary, but it is typically several weeks to several months.
The patient will have to be patient, as the recovery process can be slow and sometimes frustrating. The patient will have to attend several follow-up sessions with the surgeon and the physical therapist, to monitor the healing process and make any necessary adjustments to the treatment plan.
It is important to follow the surgeon’s and physical therapist’s instructions carefully during the recovery period, to ensure proper healing and the best possible outcome.
Risk Factors
There are several risk factors for extensor tendon lacerations, including:
- Trauma: Trauma to the hand and fingers, such as a cut or puncture wound, is the most common cause of extensor tendon lacerations.
- Occupational hazards: People who work in certain occupations, such as construction or industrial work, are at an increased risk of extensor tendon lacerations due to the potential for hand and finger injuries.
- Sports and recreation: Certain sports and recreational activities, such as rock climbing and martial arts, can also increase the risk of extensor tendon lacerations.
- Age: older people may have a greater risk of extensor tendon lacerations due to age-related changes in the tendons, making them more prone to injury.
- Rheumatoid arthritis and other connective tissue diseases: People with conditions that affect the connective tissue in the body, such as rheumatoid arthritis, are at an increased risk of extensor tendon lacerations.
- Previous hand or finger injury: People who have previously injured their hands or fingers may have a greater risk of extensor tendon lacerations due to scarring or other changes in the tendons.
- Diabetes: Diabetic patients may have a greater risk of extensor tendon lacerations due to poor circulation and altered healing capacity.
It’s important to note that having one or more of these risk factors does not necessarily mean that an individual will experience an extensor tendon laceration, but it may increase their likelihood of developing one.
Complications
There are several potential complications associated with extensor tendon lacerations, including:
- Tendon healing problems: If the tendon is not properly repaired or if the repair fails, the tendon may not heal properly, resulting in limited movement and weakness in the affected hand and fingers.
- Stiffness: The hand and fingers may become stiff and difficult to move following surgery or immobilization in a splint or cast.
- Infection: An infection may occur at the surgical site or in the hand and fingers, which can delay healing and increase the risk of complications.
- Neuroma: A neuroma is a benign growth of nerve tissue that can occur following an injury to a nerve. In the case of extensor tendon lacerations, a neuroma can develop near the site of the injury and can cause pain, tingling, and numbness.
- Complex regional pain syndrome (CRPS): CRPS is a rare but serious condition that can occur following an injury or surgery. Symptoms include severe pain, swelling, and changes in skin color and temperature in the affected hand or fingers.
- Scarring: scarring may occur at the surgical site, which may cause aesthetic concern or interfere with normal movement.
- Reduced range of motion and grip strength: Reduced range of motion and grip strength are common after an extensor tendon laceration, but with proper rehabilitation, most patients will regain the majority of their function.
It is important to follow the surgeon’s and physical therapist’s instructions carefully during the recovery period, to ensure proper healing and the best possible outcome and minimize the risk of complications.
When to See a Doctor
If you suspect that you have an extensor tendon laceration, it is important to seek medical attention as soon as possible. Extensor tendon lacerations can lead to serious complications if left untreated, so prompt medical attention is crucial.
- You should see a doctor if you have any of the following symptoms:
- Sudden loss of movement or ability to straighten a finger or thumb.
- Pain, tenderness, or swelling in the top of the hand or fingers.
- Visible cut or laceration on the top of the hand or fingers.
- Difficulty gripping or grasping objects.
- Bruising or discoloration in the affected area.
- A wound that is not healing properly, or if you have a wound that becomes red, swollen, or starts to drain pus. This can be a sign of an infection, which can delay healing and increase the risk of complications.
Your doctor will likely examine your hand and fingers and may order imaging tests such as X-rays or MRI to confirm the diagnosis and assess the extent of the injury. The doctor will then recommend a treatment plan, which may include surgery and physical therapy.
Step-by-Step Guide to Extensor Tendon Lacerations Treatment
The treatment for an extensor tendon laceration typically involves the following steps:
Consultation
The first step in treating an extensor tendon laceration is to schedule a consultation with a plastic surgeon, hand surgeon, or other medical professionals who specialize in treating hand and finger injuries. During the consultation, the doctor will examine your hand and fingers and may order imaging tests such as X-rays or MRI to confirm the diagnosis and assess the extent of the injury.
Treatment Plan
Based on the results of the examination and imaging tests, the doctor will develop a treatment plan. The plan may include non-surgical options such as splinting or casting, but surgery is often required to repair the damaged tendon.
- Surgery: If surgery is required, the procedure will typically be performed under local or regional anesthesia. The surgery may involve sewing the tendon back together, or in some cases, using a graft to repair the tendon.
- Immobilization: Following surgery, the hand and fingers will be immobilized in a splint or cast to allow the tendon to heal properly. The duration of immobilization depends on the severity of the injury, but it can be several weeks to several months.
- Physical therapy: Physical therapy will likely be recommended to regain the range of motion and strength in the affected hand and fingers. The physical therapist will guide the patient through exercises and techniques designed to improve mobility and strength in the hand and fingers.
Follow-Up Care
The patient will have to attend several follow-up sessions with the surgeon and the physical therapist to monitor the healing process and make any necessary adjustments to the treatment plan.
Recovery
Recovery time can vary, but it is typically several weeks to several months. The patient will have to be patient, as the recovery process can be slow and sometimes frustrating.
To ensure proper healing and the best possible result, it is important to follow the surgeon’s and physical therapist’s instructions carefully during the recovery period.
Conclusion
In conclusion, extensor tendon lacerations can be a serious injury that can significantly impact an individual’s ability to use their hand and fingers. These types of injuries often occur as a result of a sharp object or trauma to the hand or fingers. It is important to seek prompt medical attention if you suspect an extensor tendon laceration, as early diagnosis and treatment can greatly improve the chances of recovery.
It’s important to follow the doctor’s instructions and engage in any recommended physical therapy to aid in the healing process. With proper care and attention, individuals with extensor tendon lacerations can often regain much of their lost function and regain their ability to use their hands and fingers in their daily activities.
BOOK AN APPOINTMENT TODAY
At Dr. Colin Hong’s office, we understand that tendon lacerations can cause significant discomfort and hinder your daily activities. That is why we provide comprehensive care and treatment to help restore the normal movement of your hands with minimal scarring. Our goal is to give you the best possible outcome in a comfortable environment.
Dr. Colin Hong is one of Toronto’s most experienced plastic surgeons with over 35 years of experience. He specializes in Cosmetic, Plastic, and Reconstructive surgeries at an affordable cost for patients located in Toronto, North York, and Markham.
If you are interested in scheduling a consultation for extensor tendon lacerations or any other procedure, please contact our office at (416) 222-6986 or email us at info@drcolinhong.com. Please make sure to include your full name, email, and phone number so that we can reach you promptly. Also, a referral from your family doctor is necessary to set up an appointment with Dr. Colin Hong.
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