[Ambulatory treatment of extensor-tendon injury in general surgery]

Extensor tendon injuries are mostly treated by younger general surgeons. Good follow-up results in the zone 2, 3, 4 and 6 of VERDAN are observed only 6 to 17 percent (fig. 1), which may be explained by: 1. the complicated anatomy of the extensor tendon in zone 2 to 4, 2. lack of attention to handsurgical principles, 3. infections in up to 40 per cent, which appear especially in connection with extensive soft tissue damage, 4. posttraumatic arthrosis (fig. 3) caused by lesions of the finger-joints or temporary KIRSCHNER wire fixation. The highest restriction of movement is found in the finger-joint distal to the injury (fig. 2.) The degree of flexion deficit in all finger-joints always exceeds the degree of extension deficit (fig. 4). The extension deficit alone is, therefore, not a satisfactory criterion in follow-up. The use of KIRSCHNER wire fixation by the inexperienced and the adoption of conservation therapy for zones 1 and 2 cannot be recommended.