Extensor tendon injury in a hand – aftercare

Aftercare following surgical treatment of an extensor tendon rupture

One of the biggest challenges in connection with an extensor tendon injury is the appropriate aftercare. Why is that?

The stitched up extensor tendon requires an immobilization period of five to six weeks in order to properly heal. Immobilizing the hand or even just the injured finger for six weeks, however, bears the risk to incur severe mobility dysfunctions. This risk is particularly high if neighboring fingers are also immobilized.
A very well established approach in the aftercare following an injury to extensor tendons is the Kleinert splint.

The image shows a splint used in the dynamic aftercare of an extensor tendon suture.  

In the case of a tendon rupture a splint helps preventing the fingers from getting into an overflexed position. At the same time an elastic band takes care of stretching the fingers while at the same time ensuring that the fingers do not get strained.

What does that look like?

The splint prevents the patient from making a fist.  At the same time an elastic band is attached to the splint which will pull the injured tendon into the correct position. The patient therefore to some extent is able to perform a controlled bending motion.

The traction produced by the rubber reins ensures that the fingers may be stretched. This means that in lieu of the extensor tendons the rubber reins perform the stretching motion. Consequently, if the extensor tendons do not perform the stretching motion, the risk of straining the suture mark is not given.

What is the advantage of this type of aftercare?

The advantage consists of the avoidance of a clogged tendon due to a rigid immobilization thus to the avoidance of joint stiffening.

What are the disadvantages?

This approach should only be selected in patients who dispose of the tenacity to reliably comply with the rules attached to this procedure. Improper handling in this case could very easily lead to a further rupture to the tendon!

Extensor tendon injury:    1    2    3

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