Orthopaedic Surgery/Extensor Tendons

Extensor tendon lacerations

Extensor tendon ruptures

Mallet finger Presenting as an inability to extend the distal interphalangeal joint following blunt trauma typically related to ball sports this seemingly innocuous injury is made a bit more complicated by delay in presentation. There is a tendency then to immobilize the distal phalanx for longer than the typical 5 weeks, and perhaps run the risk that flexion will be lost. This outcome is more detrimental to hand function than is a mild extension lag especially in the small and ring fingers. Still patients place a priority on achieving full extension and the possibility of gradually reaquiring the ability to fully flex the joint is more likely than requiring the ability to actively extend the distal interphalangeal joint.

Besides delay in treatment, the other factor that can complicate treatment is a sizable boney fragment. At times a true axial load can in fact split the joint surface of the distal interphalangeal joint essentially disrupting both the extensor and flexor insertion.

The uncomplicated healing that typically occurs with a five week period of immobilization is still accompanied thereafter by what is sometimes a protracted period ( up to 4 months) of sensitivity, slight swelling and even slight erythema over the dorsum of the middle phalanx, which appears to be self limiting and perhaps reflects ongoing remodeling changes in the terminal extensor tendon.

Boutonierre deformity

Radial saggital band rupture

Extensor Pollicus Longus Rupture

Extension Lag

Tendon transfers