Primary repair of extensor tendon injuries of the hand

Knowledge of the functional anatomy of the extensor tendons with the sliding mechanism is essential for better understanding the surgical therapy and the postoperative care in the different trauma zones of the extensor tendon. In addition the localization of the injury is very important for the clinical findings, therapy, aftercare and long term prognosis. Anatomical facts, injury mechanisms and associated injuries have to be considered in the therapy concept. Several therapy possibilities are known: immobilizing with splint for the closed rupture in zone 1, reinsertion in zone III (with a ternporary Kirschner-wire-pinning), tendon suture, tendon transplantation or transposition. Controlled mobilization after suture should be aspired (similar to the one of the flexor tendon) especially after squeezing, multi tendon injuries, tendon transplantations or injuries in zone VII. Pathological and iatrogenic tendon lesions are special forms of tendon injuries.