An extensor tendon repair refers to any surgical procedure that attempts to mend injured tendons to restore proper movement and function. A tendon is a belt-like strip of connective tissue connecting muscles to the bones. Extensor tendons allow the body part to straighten out.
Tendons become injured when there is a disruption of its fibers. This can occur with any type of external force including anything from a crushing force, known as blunt force trauma, to a forceful stretching to an actual cut or split in the tendon. If the rip in the tendon detaches the muscles from the bone it is called a rupture.
The most common areas for extensor tendon repair include the hand and the knee. The extensor tendons of the hand are located close to the outside of the hand, and therefore sustain injuries easily.The knee joins the lower leg to the upper leg. Due to the complicated construction of the knee, extensors injuries are common in activities that require sudden directional changes or jumping motions earning this injury the nickname “jumper’s knee”. These stress injuries put strain on the tendon causing tears or rips.
For minor splits in a tendon a brief period of rest and immobilization may be enough to permit the tendon to heal. When the injury is severe the manual repair of the tendon may be required to restore normal movement and decrease pain. If the tendon rips apart from the bone, as seen with a tendon rupture, the muscles will no longer have the ability to move the bones. This is where an extensor tendon repair procedure is necessary to reattach the muscles to the bone.
During the surgical procedure for an extensor tendon repair, the damaged areas of the tendon are mended with stitches or sutures to bind the area together. On occasion when the tendon has sustained a severe injury, tendon excision, also called tendon resection, is necessary. This is where a portion of the tendon is removed.
Following the surgery, the injured area is placed in a splint or immobilizer for up to several weeks to keep the area stable and prevent further injury. Occasionally dynamic splints are used. These post-op devices allow for a small amount of controlled movement to decrease swelling and diminish the risk of scar tissue causing contractures or a permanent shortening of the muscle inhibiting normal movement.
To restore maximum function and mobility after extensor tendon repair, several weeks of physical therapy are recommended. Physical therapy can address pain issues as well as provide proper stretching and strengthening techniques necessary to regain normal muscle length and power.