Extensor tendon injuries occur when the tendons responsible for extending the fingers or thumb are damaged. These injuries can result from trauma, such as lacerations, crush injuries, or sports-related accidents.
Surgical Interventions per Recommendations by your Hand Surgeon
Primary Repair: In cases of clean lacerations or partial tears, primary repair may be performed to reattach the tendon ends together.
Tendon Grafting: If the tendon is severely damaged or cannot be repaired directly, a tendon graft may be taken from elsewhere in the body and used to replace the damaged tendon.
Tendon Transfer: In some cases, a neighboring tendon may be rerouted to take over the function of the damaged extensor tendon.
Complications:
Tendon Rupture: Failure of the repair or graft can lead to tendon re-rupture.
Adhesion Formation: Scar tissue may develop around the repaired tendon, limiting its movement.
Stiffness: Restricted range of motion can occur due to various factors
Infection: Surgical sites are susceptible to infection, which can hinder the healing process.
Functional Limitations
Functional limitations following an extensor tendon injury can significantly impact one's ability to perform everyday tasks. These limitations may vary depending on the severity of the injury and the effectiveness of treatment and rehabilitation. Some common functional limitations include:
Difficulty Extending the Fingers: Extensor tendon injuries can result in limited extension of the fingers or thumb. This limitation can make it challenging to perform activities that require full finger extension, such as grasping objects or typing on a keyboard.
Decreased Grip Strength: The extensor tendons play a crucial role in maintaining grip strength. Damage to these tendons can lead to weakness in gripping objects, making it difficult to hold onto items securely.
Impaired Fine Motor Skills: Fine motor skills, which involve precise movements of the fingers and hands, may be compromised following an extensor tendon injury. Tasks such as buttoning shirts, tying shoelaces, or manipulating small objects may become more challenging.
Altered Hand Functionality: Extensor tendon injuries can affect overall hand functionality, limiting the ability to perform activities of daily living independently. Simple tasks like opening jars, turning doorknobs, or writing may require extra effort or assistance.
Pain and Discomfort: Pain and discomfort are common following an extensor tendon injury, especially during movement or when pressure is applied to the affected area. Pain can further impede functionality and may affect quality of life.
Reduced Range of Motion: Scar tissue formation, stiffness, or adhesions around the repaired tendon can lead to a decreased range of motion in the affected fingers or thumb. Limited range of motion can hinder the ability to perform various movements and tasks effectively.
Functional Adaptations: Individuals with extensor tendon injuries may need to adapt their techniques or use assistive devices to compensate for functional limitations. For example, using adaptive tools with larger handles or modified grips can help overcome grip strength deficits.
Treatment Techniques Used by Hand Therapists:
Passive Range of Motion Exercises: Gentle manipulation of the fingers and hand to maintain flexibility and prevent stiffness when appropriate.
Active Range of Motion Exercises: Gradual introduction of movements involving the affected tendons to improve strength and coordination when appropriate.
Splinting: Custom Orthosis may be used to protect the repaired tendon and provide support during healing.
Scar Management: Techniques such scar mobilization reduce scar tissue formation and improve tissue mobility.
Edema Control: Modalities like compression and elevation may be employed to manage swelling.
Strengthening Exercises: Progressive resistance exercises to enhance the strength of the repaired tendon and surrounding muscles appropriate phase of healing.
Functional Training: Activities simulating real-life tasks to promote the integration of the repaired tendon into daily activities.
Patient education: Patient education on precautions and compliance with the program will play a crucial role in optimal outcome.
Overall, addressing functional limitations through comprehensive rehabilitation, including hand therapy and patient education, is essential for optimizing recovery and restoring independence in daily activities following an extensor tendon injury.