![]() Once that is done, open injuries should be explored with care under local anesthetic and with appropriate magnification. Neurovascular status should always be tested and documented before any local anesthetic is given. Any open wound to the back of the hand should raise suspicion of extensor tendon injury. Unless the injury is part of a larger trauma, and the patient needs to be treated according to the ATLS protocol, hand examination should start with an inspection. īoth a systemic and an in-depth examination of both hands is crucial, comparing like for like. Knowing whether a human bite was involved is vital as any contamination would need formal irrigation and debridement. A detailed history is crucial and must include the mechanism of injury, position of the hand and fingers at the time, age, occupation, and handedness. History and PhysicalĪccurate assessment and management are essential as it has a direct impact on livelihood and work of affected individuals. In the United States, they are equally common and are estimated to comprise more than 25% of all soft tissue injuries. In the UK, they represent up to 30% of all emergency department visits and are the most common reason to attend. The dominant hand is more likely to be injured, and the thumb tends to be most commonly damaged, followed by the index and middle fingers, but extensor tendon lacerations can occur at any site. They have been reported to cost the United Kingdom economy over £100 million each year relating to the cost of direct care and much higher when you take the loss of wages and poor productivity-related losses to the economy. Patients affected are mostly men in their thirties, and as they are the working-age group, these injuries have a great economic impact on society. Accidental injuries in younger children are seen sometimes involving flexor and extensor injuries, while much more rarely they can happen in neonates as a result of iatrogenic injury during delivery – particularly during C-section. A saw is likely to be causing injury distal to the metacarpophalangeal joint (MCPJ) and be associated with fractures, while sharp object lacerations tend to be proximal to that. ![]() Laceration with a sharp object is the most common mechanism followed by saw injuries, both having a slightly different distribution anatomically. EtiologyĮxtensor tendon lacerations are very common injuries among young manual workers. Due to their superficial location and being adjacent to the bones, extensor tendons in the hand are more prone to injury than the flexors. Describe the importance of collaboration and communication among the interdisciplinary team to improve outcomes for patients affected by extensor tendon laceration.Įxtensor tendon lacerations are relatively common injuries and, when not treated appropriately, may result in a lasting impairment of hand function.Summarize the options for rehabilitation post extensor tendon laceration.Outline the anatomy relevant to the extensor tendon laceration.Review the epidemiology of extensor tendon laceration.This activity reviews the evaluation and management of extensor tendon lacerations in the hand and highlights the role of the interprofessional team in improving care for patients with this injury. The injury mostly affects the working-age group therefore, these injuries have a great economic impact on society. The bony structures of the wrist, the pictured distal radius and ulna to the bases and proximal parts of the metacarpals are assessed including the proximal and distal row of carpal bones.Extensor tendon lacerations are relatively common injuries and, when not treated appropriately, may result in a lasting impairment of hand function. ![]() A systematic review in the MRI of the wrist is essential since wrist anatomy itself is a complex entity with small structures, pathologies and injury patterns that are manifold and involve a whole lot of different therapeutical approaches.
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