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Extensor Tendon Treatment in Pune
Get expert extensor tendon injury treatment in Pune with hand surgeons offering precision repair and rehabilitation therapy.
Overview
Your hands perform countless tasks every day, from typing and writing to gripping and lifting. At the heart of these movements are extensor tendons – strong, rope-like structures that connect your forearm muscles to your finger and thumb bones. These tendons allow you to straighten your fingers, extend your wrist, and lift your thumb.
Located just beneath the skin on the back of your hands and wrists, extensor tendons are particularly vulnerable to injury. When damaged, these injuries can significantly impact your daily activities and work performance. An extensor tendon injury occurs when these vital structures are cut, torn, or stretched beyond their limits.
While these injuries might seem less serious than other hand problems, they require prompt attention and proper treatment. Without appropriate care, extensor tendon injuries can lead to permanent disability and long-term complications that affect your quality of life.
Symptoms
Recognizing the signs of an extensor tendon injury early is crucial for successful treatment. The symptoms can vary depending on where the injury occurs and how severe it is, but common warning signs include:
Physical Signs:
- Open wounds or cuts on the back of your hand, fingers, wrist, or forearm
- Inability to straighten one or more fingers or your wrist
- Drooping finger that appears stuck in a bent position
- Swelling, pain, and tenderness around the injured area
- Weakness when trying to extend your finger against resistance
Functional Problems:
- Difficulty performing everyday tasks like typing or gripping objects
- Abnormal resting posture where your finger or wrist won’t straighten naturally
- Pain that worsens with movement or pressure
It’s important to note that these symptoms differ from extensor tendinitis, which is inflammation caused by overuse rather than a direct injury. While both conditions cause pain and movement difficulties, tendinitis doesn’t involve a complete break in the tendon structure.
Causes
Extensor tendon injuries can happen in several ways due to their location close to the skin surface:
Common Causes:
- Deep cuts or lacerations – The most frequent cause, as these tendons lie just under the skin
- Blunt trauma – Forceful impacts that can tear tendons or pull them away from bone
- Sports injuries – Particularly when a ball forcefully bends an extended finger
- “Fight bite” injuries – Cuts over knuckles from punching, often involving infection risk
- Sudden overstretching – When tendons are forced beyond their normal range
Medical Conditions:
- Rheumatoid arthritis and other autoimmune diseases that weaken tendons
- Degenerative changes that make tendons more prone to rupture
Previous injuries that have weakened the tendon structure
Risk Factors
While anyone can experience an extensor tendon injury, certain factors increase your likelihood of developing these problems:
Occupational Risks:
- Manual laborers who use their hands extensively
- Workers exposed to sharp tools or machinery
- Healthcare workers at risk of cuts or bites
Lifestyle Factors:
- Contact sports participation
- Activities involving repetitive hand motions
- Hobbies like woodworking, gardening, or crafting
Personal Factors:
- Age over 40 (tendons become less flexible)
- Smoking (reduces tendon healing capacity)
- Underlying health conditions like arthritis
- Poor compliance with previous treatment recommendations
Diagnosis
Accurate diagnosis of extensor tendon injuries requires a thorough evaluation by a healthcare professional. The diagnostic process typically includes:
Medical History: Your doctor will ask about how the injury occurred, your symptoms, occupation, and any underlying health conditions. Understanding the mechanism of injury helps determine the likely extent of damage.
Physical Examination:
- Wound assessment to evaluate the size, location, and depth of any cuts
- Function testing to check your ability to extend each finger and wrist joint
- Strength testing to identify partial versus complete tendon tears
- Sensation testing to rule out nerve damage
Specialized Tests:
- Elson’s test – A specific examination for central slip injuries where you try to extend your fingertip while the middle joint is bent
- Tendon continuity testing – Checking if the tendon can still transmit force effectively
Imaging Studies:
- X-rays to identify fractures or foreign objects
- Ultrasound to visualize tendon integrity and detect tears
MRI scans for complex cases requiring detailed soft tissue evaluation
Types
Extensor tendon injuries are classified by anatomical zones, which helps doctors determine the best treatment approach. Here are the most common types:
Zone I – Mallet Finger: This affects the fingertip joint, causing the tip to droop and making it impossible to straighten. It’s often caused by a ball hitting an extended finger or catching a finger on clothing.
Zone III – Boutonniere Deformity: An injury to the middle finger joint that, if untreated, can cause the joint to become stuck in a bent position while the fingertip hyperextends. This deformity may develop gradually after injury.
Zone V – “Fight Bite” Injuries: Cuts over the knuckles, often from punching, that are particularly dangerous due to high infection risk. These can also involve sagittal band rupture, causing the tendon to slip out of place.
Zones VI & VII – Hand and Wrist Injuries: Lacerations on the back of the hand or wrist that can significantly impact your ability to straighten your knuckles or extend your wrist. These areas are vulnerable due to the tendons’ superficial location.
Treatment
Treatment for extensor tendon injuries depends on the severity, location, and type of injury. Options range from conservative management to surgical intervention.
Non-Surgical Treatment:
Splinting is the cornerstone of conservative treatment for many extensor tendon injuries:
- DIP extension splinting for mallet finger – keeps the fingertip straight for 6-8 weeks
- PIP extension splinting for boutonniere deformity – maintains the middle joint in extension
- MCP extension splinting for knuckle injuries – protects the repair site
RICE Method for extensor tendinitis:
- Rest the affected area
- Ice to reduce swelling
- Compression with elastic bandages
- Elevation when possible
- Anti-inflammatory medications for pain relief
Surgical Treatment:
Surgical repair becomes necessary when:
- The tendon is completely severed
- More than 50% of the tendon width is damaged
- There’s a large bone fragment attached to the torn tendon
- Conservative treatment has failed
Surgical Options:
- Direct tendon repair – Suturing the torn ends together
- Tendon reconstruction – Using grafts from other body parts
- Tendon transfer – Redirecting healthy tendons to restore function
- Bone fixation – Securing bone fragments with pins or screws
Rehabilitation
Hand therapy plays a crucial role in recovery from extensor tendon injuries. The rehabilitation process is carefully structured to promote healing while preventing complications.
Initial Phase (0-2 weeks):
- Splinting to protect the repair and maintain proper positioning
- Pain and swelling management
- Patient education about activity restrictions
Early Motion Phase (2-6 weeks):
- Dynamic splinting with spring-loaded devices to allow controlled movement
- Relative motion splinting – a newer technique that encourages tendon gliding while protecting the repair
- Early active short-arc motion – limited, supervised finger movements
Progressive Strengthening (6-12 weeks):
- Gradual increase in range of motion exercises
- Tendon gliding exercises to prevent scar tissue formation
- Strengthening activities as healing progresses
Return to Function (3-4 months):
- Advanced strengthening exercises
- Work and activity simulation
- Final adjustments to optimize function
Complications
Despite advances in treatment, extensor tendon injuries can sometimes lead to complications that affect long-term function:
Common Complications:
- Adhesion formation – Scar tissue that restricts tendon movement and causes stiffness
- Tendon rupture – Re-tearing of the repaired tendon, especially in the first few weeks
- Extensor lag – Persistent inability to fully straighten the affected finger or wrist
- Loss of flexion – Difficulty bending the finger due to scar tissue
Deformities:
- Boutonniere deformity – Permanent bending of the middle joint with fingertip hyperextension
- Swan neck deformity – Less common pattern with middle joint hyperextension and fingertip bending
Other Issues:
- Chronic stiffness despite extensive therapy
- Infection, particularly with bite injuries
- Need for additional surgery to release scar tissue
Prevention
Preventing extensor tendon injuries focuses on protecting your hands during activities that pose risks:
Safety Measures:
- Use proper protective equipment like gloves during manual work
- Handle sharp tools and objects carefully
- Avoid putting your hands in dangerous positions during sports or work
- Learn proper techniques for activities involving repetitive hand motions
Health Maintenance:
- Warm up before physical activities and stretch afterward
- Take regular breaks during repetitive tasks
- Address underlying conditions like arthritis that can weaken tendons
- Avoid smoking, which impairs healing
- Maintain overall hand and wrist flexibility through regular exercise
Workplace Safety:
- Follow safety protocols when using machinery or sharp tools
- Report unsafe working conditions
- Use appropriate personal protective equipment
- Receive proper training for job-related hand activities
Living With Scaphoid Fracture
Recovery from an extensor tendon injury requires patience, commitment, and realistic expectations. Understanding what to expect can help you navigate the healing process successfully.
Recovery Timeline: The healing process varies significantly based on injury severity and treatment approach. Simple extensor tendinitis may improve within weeks, while surgically repaired tendons typically require 3 months before they’re strong enough for normal use. Full recovery can take 4-6 months or longer.
Daily Life Adjustments: During recovery, you’ll need to modify your activities to protect the healing tendon. This includes avoiding heavy lifting, contact sports, and activities that could re-injure the area. Your therapist will guide you on when it’s safe to gradually return to normal activities.
Long-term Expectations: Most people achieve good functional recovery with proper treatment and rehabilitation. However, some may experience minor limitations such as slight extensor lag or reduced grip strength. These residual effects are often manageable and don’t significantly impact daily activities.
Monitoring Your Progress: Stay alert for signs of complications such as increased pain, swelling, redness, or sudden loss of movement. Report these symptoms to your healthcare provider immediately, as early intervention can prevent more serious problems.
Key Takeaways
- Extensor tendons are essential for finger and wrist extension, and injuries can significantly impact hand function
- Common injuries include mallet finger and boutonniere deformity, each requiring specific treatment approaches
- Early diagnosis through physical examination and appropriate imaging leads to better outcomes
- Treatment ranges from splinting for minor injuries to surgical repair for complete tendon lacerations
- Hand therapy is crucial for optimal recovery, using techniques like dynamic splinting and relative motion splinting
- Complications such as adhesion formation and tendon rupture can be minimized with proper treatment compliance
- Prevention focuses on hand safety and managing underlying health conditions
- Most patients achieve good functional recovery with dedicated rehabilitation and adherence to treatment protocols
At Sancheti Hospital, we have witnessed firsthand how extensor tendon injuries can significantly impact a person’s daily life and work capabilities. Our facility understands that each patient’s journey to recovery is unique, and we’re committed to providing comprehensive care that addresses not just the immediate injury, but also the long-term functional goals of our patients.
Our multidisciplinary team, including orthopedic surgeons, hand therapists, and rehabilitation specialists, works together to develop personalized treatment plans that optimize healing and restore hand function.
We utilize the latest techniques in tendon repair, dynamic splinting, and hand therapy to ensure our patients achieve the best possible outcomes. Whether you’re dealing with a simple mallet finger or a complex tendon reconstruction, we’re here to guide you through every step of your recovery journey with expertise, compassion, and unwavering support.
Meet Our Hand & Microvascular Specialists
Patient Stories & Experiences
The pain in my left knee left me feeling helpless for years. After my treatment here, I can finally say I'm pain-free.
Vinita Singh
The nerves were swollen, and the body went numb. But thanks to Sancheti Hospital, I got a second life!
Parvati
I finally could walk again, a relief I've only felt after the hip pain surgery. I thank the doctors at Sancheti Hospital for their help.
Balaji Kharat
I'm a police officer, and I'm extremely thankful to Sancheti Hospital for treating my fracture without surgery.
Shantilal
My life has completely changed after the knee replacement surgery at Sancheti Hospital. It's like I can finally live again!
Kalpana Lepcha
The knee pain I've carried for years finally went away with the help of Sancheti Hospital.
Karuna
I can't believe that I get to finally live a normal and happy life, all thanks to the knee surgery I had at Sancheti Hospital.
Kishore Bhosle
Frequently Asked Questions
Can I shower or get my splint wet during treatment?
Keep your splint completely dry. Use a plastic bag to cover it while showering. If it gets wet, contact your doctor immediately as wet splints can cause skin problems and delay healing.
When can I return to work after extensor tendon surgery?
Office workers can typically return in 1-2 weeks with restrictions. Manual laborers may need 8-12 weeks off work. Your doctor will provide specific guidelines based on your job requirements and healing progress.
Is it normal for my finger to look different after treatment?
Minor changes in finger appearance are common. Some patients have slight swelling or different finger positioning that improves over time. Significant deformities should be reported to your doctor immediately.
How much will extensor tendon treatment cost?
Costs vary based on injury severity and treatment type. Splinting treatments are less expensive than surgical repair. Check with your insurance provider and hospital billing department for specific cost estimates.
Can I drive with a hand splint?
Driving depends on which hand is injured and your splint type. You must be able to grip the steering wheel safely and operate all controls. Consult your doctor before driving and check with your insurance company about coverage.
