2 Management of Complications of Extensor Tendon Surgery

David Elliot and Thomas Giesen

Abstract

The complications following primary management of extensor injuries can be considered generally as (1) those relating to the anatomy and function of the tendons themselves, (2) their ability to glide within their immediate surrounds after trauma, and (3) the fact that the end result of treatment is rarely determined simply by the state of the extensor tendon as, taken in the wider perspective, dorsal injuries are frequently complex. Our basis of primary management of extensor tendon injuries, as with flexor tendon injuries, is early repair and early mobilization, with appropriate suture techniques and rehabilitation to protect the repairs. By virtue of anatomical and physiological variation along their length, and unlike the flexors, a single system of primary surgery and rehabilitation cannot be applied to extensor tendon injuries. Primary management must be tailored to the particular part of the extensor system injured, and each part of the extensor system from the proximal forearm to the tip of the digits is liable to different complications. Therefore, it is more practical to consider the likely complications which may ensue in each of Verdan’s divisions of the extensor system separately (Fig. 2‑1). ^{1 , 2 , 3} Prophylaxis by appropriate primary management is often more effective than secondary treatment of an established complication, so this also needs to be considered.

Key words

extensor tendon - extensor tendon repair - extensor tendon reconstruction - extensor tendon rehabilitation - extensor tendon secondary surgery - complications of extensor tendon repair

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