Extensor Tendon Injury

By | June 10, 2022

The structure of the human hand is extremely complex and the fingers in particular are extremely delicate. Due to their great mobility, they can easily be injured in everyday life when handling tools, gardening and around the house. If you have a cut, saw, or animal bite your finger or hand, you should carefully check for an extensor tendon injury.

What is an extensor tendon injury?

An extensor tendon injury occurs either in the so-called end phalanx (third phalanx) or the middle phalanx (second phalange) as well as the first phalanx of a finger of the human hand. For what is the definition of dyslexia, please visit healthknowing.com.

This leads to a tear in one of the two extensor tendons that run along the extensor sides of the fingers. In the wrist area, the extensor tendons are surrounded by so-called tendon sheaths and are therefore protected more effectively. In the area of ​​the fingers, this is no longer the case, which is why this injury can also occur with a small amount of force in the home or during sports.

The affected finger joint can be bent, but can no longer be stretched afterwards. Swelling occurs, which is accompanied by pain. The affected finger joint hangs down like a hammer. This is particularly the case with an extensor tendon injury on the third phalanx.


The causes of an extensor tendon injury can be varied. In addition to tendon injuries in the home and in sports, accidents in the handicraft sector can also be the cause.

These include cuts or saw injuries that result in a severed extensor tendon. The bite of animals, especially dogs, can lead to an extensor tendon injury.

Typical Symptoms & Signs

  • Affected finger can no longer be stretched
  • possibly the phalanx hangs down

Diagnosis & History

Imaging procedures, such as X-rays, are usually only used to diagnose an extensor tendon injury if bony structures are also injured, because the tendons are not visible on the images.

Therefore, in the event of a cut, saw or bite injury, all fingers of the injured hand are examined for a torn tendon. If the end phalanx of a finger is affected, there is a so-called covered extensor tendon injury. Only in this case is an X-ray useful in the diagnosis.


An extensor tendon injury primarily leads to relatively severe pain. These occur in the respective region, but in many cases also spread to neighboring regions. In most cases, the patient can no longer stretch or lift his finger, which can lead to hereditary restrictions in everyday life.

The phalanx itself hangs down, which can also lead to aesthetic problems. If the pain caused by the injury persists, it can lead to psychological problems or even depression. Early diagnosis and treatment of this injury has a very positive effect on the course of the disease. In most cases, treatment is carried out with the help of medication and various therapies.

However, long-term use of painkillers can damage the stomach and should therefore be avoided. With the therapies, the movement of the finger is restored. Complications usually do not occur and in most cases no surgical interventions are necessary. The patient’s life expectancy is not affected by the extensor tendon injury.

When should you go to the doctor?

A doctor should be consulted if there are complaints and irregularities on the hand and fingers after a fall, an accident or the effects of violence. If pain or restricted mobility of the fingers is noticed as a result of sports or other physical activities, it must be checked whether this is a temporary or permanent phenomenon. If the symptoms persist for several hours, days or weeks, a doctor is needed. Further investigations are also necessary as soon as there is an increase in irregularities. If the symptoms decrease after a restful night’s sleep or sufficient cooling of the hand, a doctor is usually not required. In these cases, it is a reaction of the organism that arose due to an overload.

In the future, the body’s limits and needs should be responded to in good time, otherwise there could be permanent damage or impairment. If the fingers can no longer be fully straightened or if the affected person is unable to form a fist, a doctor should be informed of the observations. Swelling, changes in the appearance of the skin or a decrease in the usual strength in the hand must also be examined and treated. If pain is present, painkillers should only be taken after consultation with a doctor.

Treatment & Therapy

Treatment for an extensor tendon injury depends on the type and severity of the injury. The age of the crack also plays a role. It is important to sew up completely torn tendon ends again as soon as possible. If this is not possible, the tendon can also be restored by means of tendon braids or wire sutures.

It is therefore important for the patient to consult a doctor as early as possible. The ends of the extensor tendons do not retract like the flexor tendons, so the extensor tendon injury can usually be stitched up under local anesthesia. If the extensor tendon injury occurs in the end phalanx of the finger, applying the so-called Stack’s splint causes the otherwise downward hanging end phalanx to be overstretched.

This allows the two tendon ends to grow together again. The central joint remains flexible up to 90 degrees during the entire immobilization phase. After the healing phase, patients can initially stretch the affected phalanx ten degrees less than their other fingers. After a few weeks or months, however, the scar tissue on the tendon recedes so that the ability to stretch improves again.

In general, the injured finger joints are immobilized for about six to eight weeks. In most cases, the fingers can then be moved again immediately and used normally without the need for physiotherapeutic applications. If this does not succeed easily, exercises with a physiotherapist or occupational therapist are useful. Healing disorders due to infections and secondary bleeding are extremely rare in the case of an extensor tendon injury.


Since extensor tendon injuries usually occur as a result of accidents in the home or in sports or at work, they can only be prevented to a limited extent. When working with cutting or sawing tools, it is fundamentally important to wear appropriate protective clothing and, above all, safety gloves in order to reduce the risk of injury and to rule out the involvement of the tendons as far as possible in the event of a cut injury.


Follow-up care following the suturing of the injured tendon is not considered easy. The extensor tendon must be immobilized for a few weeks until it has healed. However, if the injured finger is immobilized in a stretched position for six weeks, there is a risk of serious movement disorders. For this reason, special post-treatment is required.

A special splint is used, which prevents maximum bending of the fingers. At the same time, an elastic band ensures that the fingers can be stretched and the injured extensor tendons can still be relieved. The splint prevents the fist from closing. The elastic, which is connected to the splint, pulls the injured tendon into a stretch.

This gives the patient the opportunity to make bending movements up to a certain point. The tendon therefore does not remain in the immobilized position, which in turn counteracts the risk of joint stiffness. The patient visits an occupational therapist three to four times a week for follow-up treatment. In the protective position, the individual finger joints move there.

After about six to eight weeks, the patient can gradually remove the protective splint and carefully begin active exercises. From the 8th week, more intensive exercises are also possible and the splint no longer needs to be put on at night. Strengthening exercises take place after twelve weeks.

You can do that yourself

In everyday life, it is particularly important to relieve the hand when performing all the tasks that arise. To avoid situations of excessive demands, breaks should be taken in good time. The gripping function should not be overused. When exercising sporting activities, fulfilling professional tasks or in the household, it should be noted that the human organism has limits in its ability to be fulfilled.

In addition to a sufficient break, home remedies can be used to support regeneration. For example, the horse ointment helps to improve general well-being and alleviate symptoms. In the case of severe irregularities, it is necessary to immobilize the hand.

Severe pain is characteristic of the disease. These can lead to an immense impairment in everyday life, as they lead not only to physical disorders but also to mental stress. Mental techniques often help in overcoming adversity. They promote inner balance and often represent a necessary balance. When dealing with the disease, relaxation methods such as yoga or meditation can therefore be used.

Sick people should ask people from their social environment for help in carrying out certain physical activities as soon as they cannot do them to a sufficient extent themselves. It is therefore often necessary to restructure the way you deal with everyday life before you can recover.

Extensor Tendon Injury