Overview
Tendinitis of the extensor tendon of the hand involves inflammation or injury to the tendons responsible for extending the fingers and thumb, often leading to pain, swelling, and reduced function.Diagnosis
Clinical presentation includes localized pain, swelling, and difficulty extending the fingers or thumb.
Imaging (e.g., ultrasound, MRI) may be used to assess tendon integrity and rule out other injuries 1.
Grading systems often categorize severity based on tendon involvement and functional impairment 1.Management
First-line: Early active mobilization without splints or sutures for partial lacerations greater than half the tendon width, initiated immediately post-injury 1.
Exercises: Non-resistive active motion for 4 weeks followed by resistive exercises 1.
Return to Work: Patients can resume normal duties after 6 weeks 1.
Surgical: Microsurgical reconstruction with vascularized tendon grafts and flaps (e.g., radial artery forearm flap, dorsalis pedis flap) for severe defects 2.Special Populations
Manual Workers: Conservative management without splints or sutures appears safe and effective for partial extensor tendon lacerations 1.
No specific guidance provided for pregnancy, pediatrics, elderly, or comorbidities based on the given abstracts.Key Recommendations
Early initiation of non-resistive active motion without splints or sutures is safe and effective for partial extensor tendon lacerations greater than half the width, allowing return to work after 6 weeks (Evidence: Moderate 1).
For severe extensor tendon defects requiring surgical intervention, consider microsurgical reconstruction using vascularized tendon grafts and flaps (Evidence: Expert opinion 2).
Exclude injury zones I, III, and V of fingers; and zones I and III of the thumb from conservative management protocols due to higher risk (Evidence: Moderate 1).References
1 Al-Qattan MM. Conservative management of partial extensor tendon lacerations greater than half the width of the tendon in manual workers. Annals of plastic surgery 2015. link
2 Desai SS, Chuang DC, Levin LS. Microsurgical reconstruction of the extensor system. Hand clinics 1995. link