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Extensor tendon repairs: consensus, current guidelines and recommendations.

Jin Bo Tang1, Carlos Henrique Fernandes2, Donald Lalonde3

  • 1Department of Hand Surgery, Affiliated Hospital of Nantong University, China.

The Journal of Hand Surgery, European Volume
|August 13, 2025
PubMed
Summary
This summary is machine-generated.

Experts propose a simpler extensor tendon classification, aligning it with flexor tendon zones for easier surgical decisions and consistent treatment of acute extensor tendon injuries.

Keywords:
Classification of extensor tendonsextensor tendon injuriesextensor tendon repairextensor tendon zonesrehabilitation

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Trauma Surgery

Background:

  • The existing classification for extensor tendon zones lacks recent updates and expert consensus.
  • Acute extensor tendon injuries require standardized and effective treatment guidelines.

Purpose of the Study:

  • To achieve expert consensus on a revised classification for extensor tendon zones.
  • To establish evidence-based treatment and rehabilitation guidelines for acute extensor tendon injuries.
  • To simplify the clinical approach to extensor tendon injuries by aligning with flexor tendon principles.

Main Methods:

  • A panel of international experts convened to discuss and provide consensus on extensor tendon injury classification.
  • Diverse expert opinions were gathered regarding classification and zone-specific treatment strategies.
  • Review of current surgical repair principles and rehabilitation protocols for both flexor and extensor tendons.

Main Results:

  • A consensus was reached to adapt a simpler classification system for extensor tendons, mirroring the flexor tendon classification.
  • Specific attention and tailored treatment approaches are recommended for distal extensor tendon zones.
  • General surgical repair principles and rehabilitation protocols for flexor tendons can be applied to other extensor tendon zones.

Conclusions:

  • Adopting a unified classification for both flexor and extensor tendons will streamline surgical decision-making.
  • Standardized treatment and rehabilitation protocols are expected to improve outcomes for acute extensor tendon injuries.
  • The proposed classification and guidelines aim for wider clinical adaptation and improved patient care.