Results of Primary Extensor Tendon Repair of the Hand With Respect to the Zone of Injury

BACKGROUND: Laceration of the hand extensor tendons is common in the upper extremities, causing soft tissue trauma. These tendons, because of their superficial location and lying adjacent to bones, have a greater tendency to be injured than flexor tendons. OBJECTIVES: The aim of this study was to determine the results of primary repairs of lacerated extensor tendons of the fingers, with respect to the zone of injury, and also whether the results are different according to the anatomical zone in which they occur. PATIENTS AND METHODS: During a period of two years and four months, 32 patients with open wounds and lacerated extensor tendons of the hand were hospitalized and underwent surgery. Repairs were done by a modified Kessler technique using 0 - 4 nylon suture. After repairing, the wrist was splinted for four weeks. Patients were followed-up for 12 months and the results were evaluated according to the Miller’s scoring system. RESULTS: A total of 72 extensor tendons were repaired. The mean age of the patients was 24.6 years. The best results were obtained in zones 3 and 5 (84% and 88% respectively), and the worst results were seen in zones 1, 2 and 4, P = 0.01. Wound infections or re-ruptures were not seen. CONCLUSIONS: Repair of extensor tendon cuts on the dorsal surface of the hand and forearm were associated with better results in zones 3 and 5 than in zones 1, 2 and 4. Repair by the modified Kessler suture method provides proper stability at the site of the tendon cut.