General Surgery - Extensor Tendon Injury

Your extensor tendons allow you to straighten your fingers. They attach the muscle belly in your forearm, to the bones in the fingers.

What are the signs of an extensor tendon injury and why is it important to be treated?

• A cut across the back of your wrist, hand or finger
• Unable to fully straighten thumb or finger
• Finger or thumb drooping downwards
• Pain on trying to straighten the finger or thumb

A hand doctor will examine the tendons in your hand to see if a repair is needed.

What does the operation involve?

The operation may involve a local anaesthetic, general anaesthetic or regional anaesthetic (local anaesthetic is injected in your shoulder to numb your arm).

The cut on your hand will be made slightly bigger to find the two ends of the tendon and this will be stitched together. At the end of the operation, you will have a plaster cast on the palmar side of your hand going from your fingertips to mid forearm.

What should I expect after surgery?

It takes up to 12 weeks for the tendon to recover.

The plaster cast applied at the end of the operation will be changed to a light-weight thermoplastic splint by the hand therapist 3-5 days after the procedure. This is to protect the newly repaired tendon.

The splint will need to be worn all the time for 4-6 weeks and then as advised by your hand therapist. You will also be given an exercise regime to follow to get back to normal function.

Approximate timescales for returning to activity:

• Driving - 8-10 weeks
• Contact sports/heavy lifting - 12 weeks

Please discuss specific activities with your therapist and they will be able to guide you as each patient and injury is individual.

What are the risks of surgery?

• Bleeding: a small amount of bleeding into the dressing is normal. It is important to keep your hand above heart level and squeeze your fingertip for 5-10 minutes and this should stop. If your dressing becomes soaked with blood, please contact our dressing clinic on the phone number at the back of this leaflet
• Infection: Please complete the course of antibiotics you have been given. This will reduce the risk of infection. If you have any signs of infection such as redness, foul smelling/yellowish discharge, excessive pain, please call the dressing clinic phone number or attend A&E for urgent review
• Tendon rupture: the tendon can snap after repair, especially if you resume activities sooner than recommended. This will require an assessment and another operation to stitch the tendon back together again
• Pain, swelling, numbness and pins and needles: this settles down but if it persists beyond a few weeks, please make your therapist aware
• Tendon adhesions and/or scarring: There is a risk of stiffness following tendon surgery, but with hand therapy the risk is less. Without hand therapy, the tendons will quickly form scar tissue and stick together causing stiffness. This may require a further operation to remove the scar tissue so that you can move your hand properly

If you have any of the above-mentioned issues, please contact the plastic surgery dressing clinic on 0161 206 5898 (Monday to Friday 8am - 4pm). Please discuss with your hand therapist for movement related issues.