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Updated: Jun 11, 2026

A Novel Tenorrhaphy Suture Technique with Tissue Engineered Collagen Graft to Repair Large Tendon Defects
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Extensor Tendon Repair.

Varun Arvind1, Daniel Y Hong1, Robert J Strauch1

  • 1Columbia University Medical Center, New York, NY.

JBJS Essential Surgical Techniques
|October 23, 2024
PubMed
Summary
This summary is machine-generated.

Hand surgeons can effectively treat extensor tendon injuries using zone-specific repair techniques. Timely repair and tailored rehabilitation, like static splinting, lead to good functional outcomes for patients.

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Traumatology

Background:

  • Extensor tendon injuries are common and require prompt surgical attention.
  • Diagnosis relies on physical examination, including the tenodesis effect, to assess tendon continuity.
  • Injuries are classified into nine distinct zones, guiding treatment strategies.

Purpose of the Study:

  • To outline zone-specific surgical techniques for extensor tendon injuries.
  • To discuss alternative repair methods and nonoperative management options.
  • To highlight the importance of tendon thickness in selecting appropriate sutures.

Main Methods:

  • Suture techniques vary based on injury zone and tendon thickness.
  • Zone I and II injuries may utilize "figure of 8" or running sutures.
  • Zones III-VII often involve core sutures supplemented by running sutures.

Main Results:

  • The running interlocking horizontal mattress (RIHM) technique is faster and creates a stiffer repair.
  • Good to excellent clinical results have been reported for RIHM in zones IV and V.
  • Acute extensor tendon repairs show good long-term outcomes, with flexion deficits being more common than extension loss.

Conclusions:

  • Techniques should be tailored to tendon thickness, with running sutures applicable to all zones.
  • Core sutures are most effective in zones III-VII.
  • Dynamic rehabilitation may not offer superior long-term benefits over static splinting for extensor tendon injuries.