Chronic Lacerations of Extensor Tendons

Angela A. Wang and Michelle Gerwin Carlson History and Clinical Presentation

A 66-year-old right hand dominant man sustained a deep laceration to the dorsum of his right wrist when a plate glass mirror fell on it. He was evaluated at a local emergency room and was informed he would need surgery, but he wanted to be treated at another institution. Seventeen days later, he presented to the office with the complaint that he could not lift his fingers.

Physical Examination

A well-healed 5-cm transverse laceration is noted on the dorsum of the right wrist just proximal to the edge of the extensor retinaculum. The patient lacked active extension of the index, long, and ring fingers at the metacarpophalangeal joints, as well as the thumb. In addition, he had a lack of extension of the wrist radially. The abductor pollicis longus, extensor pollicis brevis, and the small finger extensors were intact. Sensation in the distribution of the superficial radial nerve was intact (Fig. 35-1).

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