How to deal with finger tendon strain

When you strain the tendons of your fingers, you need to pay attention to the wound. If there is a break or a large piece of it, or an avulsion fracture, then it is recommended to undergo surgical treatment and fixation in a timely manner. The most important thing is that you cannot use these parts again after the tendon is strained.

(i) Extensor tendon insertion rupture is usually caused by puncture wounds, sudden flexion of the distal interphalangeal joint, and avulsion of the extensor tendon attachment point. Local cutting injuries may also cause severance. It manifests as hammer finger deformity, and some patients have avulsion fractures.

1. After debridement of the open wound, the tendon is sutured, the finger is placed in hyperextension of the distal interphalangeal joint and flexion of the proximal interphalangeal joint to relax the extensor tendon, and fixed with plaster or aluminum plate for 4 to 6 weeks.

2. Close the wound and fix it in the above position for 4 to 6 weeks. If accompanied by a larger avulsion fracture, early surgery can be performed, using the "wire pull-out method" to fix the fracture fragments, and external fixation with plaster or aluminum splints.

3. In old injuries, the proximal tendon retracts, forming a scar at the rupture site, causing the tendon to relax. Those with minor impact on function can be left untreated. If the function is greatly affected, surgical treatment is performed. An S-shaped incision is made on the dorsal side of the distal interphalangeal joint, the skin flap is turned over, and the fascia is overlapped and sutured. Fix in the above position for 4 to 6 weeks after surgery.

(ii) When the central bundle of the extensor tendon is ruptured, the dorsal side of the proximal interphalangeal joint protrudes when the finger is flexed. This area is easily injured and is often accompanied by a rupture of the central bundle. Normally, the central bundle and the lateral bundles are on the dorsal side of the long axis of the finger. After the central bundle is ruptured, the lateral bundles can still extend the finger. If the central bundle is not repaired in time, as the fingers flex, the two side bundles will gradually slide toward the palm side. At this time, the lateral bundles will not be able to extend the fingers, but will cause the proximal interphalangeal joint to flex and the distal interphalangeal joint to hyperextend, forming a typical "buttonhole" deformity.

(III) Injuries to the extensor tendons of the dorsum of the hand, dorsum of the wrist, and forearm should all be treated with primary suture of the ruptured extensor tendons, which has a better effect. When the dorsal part of the wrist is broken, the corresponding part of the dorsal transverse wrist ligament and synovial sheath should be cut open so that the tendon is directly located under the skin.