Fundamentals of Extensor Tendon Injuries

The extensor tendons of the hand lie relatively superficially in the dorsum, making them highly vulnerable in penetrating or open injuries, representing a frequent consultation of the plastic /hand surgeon. The complex architecture of the extensor system involves a series of structural components that participate in a synergistic function, which include the extensor tendons, the retinacular ligaments, the interosseous and lumbrical muscles form an apparatus whose balance must be respected. Injuries can range from simple clean partial lacerations to complex open injuries associated with partial/total loss of function with loss of skin covering. Given the complexity and wide spectrum of clinical presentations, the plastic/hand surgeon must know in detail the basic concepts of hand exploration, the clinical features in extensor tendon injuries, classification, individualized types of treatment, and associated complications. This chapter will attempt to provide a concise overview of extensor tendon injuries of the hand.