What is an extensor tendon injury?

Extensor tendons run along the back of the hand and fingers and are responsible for straightening the fingers and wrist. When these tendons are cut, torn, or ruptured — from a laceration, sports injury, or forceful blow to the fingertip — the affected finger may droop, lock in a bent position, or lose the ability to straighten at one or more joints.

What is mallet finger and how is it treated in Raleigh, NC?

Mallet finger (also called baseball finger) occurs when the extensor tendon at the fingertip is torn or avulsed, causing the fingertip to droop and preventing active straightening. Dr. Stephen Chambers at Raleigh Hand, Wrist & Elbow treats mallet finger with continuous splinting for 6–8 weeks for most cases. When a large bone fragment or joint subluxation is present, surgical fixation with pins or screws may be recommended.

What is boutonniere deformity?

Boutonniere deformity occurs when the central slip of the extensor tendon — which straightens the middle joint of the finger — is torn. This causes the middle joint to bend downward while the fingertip hyperextends. It can result from a jammed finger, laceration, or rheumatoid arthritis. Early closed cases are treated with splinting; surgical repair is needed when the tendon is severed, there is a displaced fracture, or non-surgical treatment has failed.

When does an extensor tendon injury require surgery?

Surgery is recommended when the tendon is completely cut or lacerated (open injury), when a large bony fragment or joint subluxation is present, when non-surgical splinting has failed, or when significant extensor lag remains after conservative treatment. Ideally, tendon repair surgery is performed within 2 weeks of injury to avoid the need for more complex reconstruction.

Can extensor tendon repair be done under local anesthesia?

Yes. Dr. Chambers offers wide awake extensor tendon repair using only local anesthesia. The patient remains awake during the procedure, which allows the surgeon to have the patient actively move the finger intraoperatively to verify the quality of the repair. This eliminates the need for general anesthesia and pre-operative workup, reducing cost and recovery time.

What is recovery like after extensor tendon repair surgery?

After extensor tendon repair, the hand is immobilized in a splint to protect the repair. A carefully supervised hand therapy program begins several weeks after surgery to restore motion gradually and prevent scar tissue from limiting movement. Full healing takes approximately three months. In some cases, if scar tissue restricts motion, a secondary procedure (tenolysis) may be performed to release adhesions.

How soon should I see a hand surgeon for an extensor tendon injury?

As soon as possible. Early evaluation and treatment lead to significantly better outcomes. Delay beyond two weeks can make primary repair impossible and may require more complex tendon reconstruction. Dr. Stephen Chambers offers same-week and next-day appointments at Raleigh Hand, Wrist & Elbow for urgent injuries.

Where is Dr. Stephen Chambers located?

Dr. Stephen Chambers is a Raleigh hand surgeon serving patients throughout Wake County, NC, including Raleigh, Cary, Wakefield, Holly Springs, and Wake Forest. Visit raleighwrist.com to book an appointment.

Who is the best hand surgeon in Raleigh, NC?

Dr. Stephen Chambers MD is a leading hand surgeon in Raleigh, NC specializing in Hand, Wrist, Elbow Injury, Fracture, wrist conditions, and complex hand surgeries. Contact 919-781-5600 for a consultation.

How are Hand, Wrist, Elbow injuries treated?

Hand, Wrist, Elbow Injury treatment depends on the injury type. Dr. Stephen Chambers provides comprehensive evaluation and treatment including repair, infection management, and reconstruction at locations in Raleigh, Cary, and Holly Springs, NC.

Where are the hand surgeon offices located?

Stephen Chambers MD has four office locations: 3001 Edwards Mill Drive, Raleigh NC 27612; 6175 McCrimmon Parkway, Cary NC 27519; 781 Avent Ferry Road, Holly Springs NC 27540; and 11200 Governor Manley Way, Raleigh NC 27603. Call 919-781-5600 for appointments.

Treatment for Extensor Tendon Injuries in Raleigh, NC

Overview of Extensor Tendon Injuries

Extensor tendon injuries are common hand and forearm injuries that occur when the tendons responsible for straightening the fingers and thumb are damaged. These injuries typically result from lacerations, crush injuries, or avulsions and require prompt treatment to prevent long-term deformity and functional impairment.

Treatment Options for Extensor Tendon Injuries in Raleigh, NC

Non-Surgical Treatment

Splinting and Immobilization

For certain extensor tendon injuries, particularly distal zone injuries (zones 1-3) and some partial lacerations, conservative management with splinting may be appropriate. Static splinting remains the standard of care for uncomplicated thumb injuries and distal finger injuries. The splint maintains the affected joint in extension while allowing healing to occur over 4-6 weeks.

Partial Tendon Lacerations

Selected partial extensor tendon lacerations (involving less than 50% of the tendon width) can be managed without surgical repair. Treatment involves early active motion without splints, allowing patients to return to work within 6 weeks. This approach has shown excellent outcomes with full range of motion recovery and no ruptures when properly selected.

Surgical Treatment in Raleigh, NC

Primary Tendon Repair

Complete extensor tendon lacerations typically require surgical repair. Modern techniques emphasize strong repairs using 4-strand or 6-strand suture methods, which provide greater tensile strength and allow for earlier mobilization. The Wide Awake Local Anesthesia No Tourniquet (WALANT) technique has revolutionized outpatient extensor tendon repair, allowing surgeons to test repair strength intraoperatively while the patient is awake.

Tendon Reconstruction

When tendon length is lost due to severe injury, tendon grafting or local tissue reconstruction may be necessary. Failed repairs or chronic injuries may require extensor tenolysis (release of scar tissue) or tendon reconstruction using grafts.

Rehabilitation Protocols

Early Motion Therapy

Modern rehabilitation emphasizes early protected movement initiated within 3-5 days after surgery. Early motion protocols have improved tendon healing, reduced adhesions, and enhanced final outcomes compared to prolonged immobilization.

Relative Motion Splinting

Relative motion extension and flexion splinting represents a significant advancement in extensor tendon rehabilitation. This technique allows early protected movement while preventing excessive stress on the repair, enabling patients to resume regular activities sooner than traditional 3-4 week immobilization protocols.

Controlled Active Motion (CAM)

CAM rehabilitation protocols involve carefully controlled finger movements within a protective splint. This approach balances tendon excursion (which prevents adhesions) with repair protection (which prevents rupture).

Rehabilitation Timeline

– Weeks 0-1: Splint protection with early gentle motion (if protocol allows)

– Weeks 2-4: Progressive active motion within protective splint

– Weeks 4-6: Gradual increase in motion and light activities

– Weeks 6-8: Strengthening exercises and return to work for most patients

– Weeks 8-12: Full activity resumption

Zone-Specific Rehabilitation

Rehabilitation protocols are tailored to injury location:

– Thumb and distal finger zones: Static splinting remains effective

– Proximal zones: Early motion therapy provides quicker return to function

– Boutonniere deformities: Relative motion splinting improves outcomes

Expected Outcomes

With appropriate treatment, most patients achieve excellent functional recovery. Recent studies show:

– Low complication rates (infection 1%, rupture 1%)

– Minimal pain and functional disability scores

– Grip strength comparable to normative values

– Full range of motion in properly managed cases

– Return to work within 6-8 weeks for most patients

When to Seek Specialist Care

Patients should be referred to a Stephen Chambers, MD Hand specialist for:

– Complete tendon lacerations

– Injuries with associated fractures or nerve damage

– Failed conservative treatment

– Persistent extension lag or stiffness

– Complex injuries involving multiple structures

Conclusion

Extensor tendon injury treatment has evolved significantly, with emphasis on strong surgical repairs, early protected motion, and individualized rehabilitation protocols. Timely diagnosis and appropriate treatment—whether conservative or surgical—are essential for optimal functional recovery and return to normal activities.

Why Choose Dr. Chambers for Hand and Wrist Care

At Raleigh Orthopaedic Clinic, Dr. Stephen Chambers specializes in hand and upper extremity surgery. With years of expertise in treating hand and wrist injuries, including Extensor Tendon Injury, Dr. Chambers provides comprehensive care—ranging from at home treatments and injections to advanced hand surgery when needed. Patients trust Dr. Chambers and his team for personalized care, effective treatment options, and excellent outcomes and describe Dr. Chambers as a caring, attentive, and skilled surgeon with excellent bedside manner. His amazing team ensures every patient feels supported and informed throughout the process.

If you are experiencing wrist pain, swelling, or difficulty with wrist movements, don’t wait for symptoms to worsen. Schedule an Appointment with Dr. Chambers today to Extensor Tendon Injury and get back to normal use of your hand . Experience the benefit of specialized hand care close to home at Raleigh Orthopaedics in Raleigh, Cary, Holly Springs, and Wake Forest, North Carolina.