Operative repair or conservative treatment for partial laceration of the extensor tendons of the hand

Report By: Martin Smith - Specialist Registrar
Search checked by Bruce Martin - Clinical Fellow
Institution: Manchester Royal Infirmary
Date Submitted: 1st March 2000
Date Completed: 25th July 2000
Last Modified: 11th April 2001
Status: Green (complete)

Three Part Question

In [patients with partial extensor tendon lacerations] does [surgical repair or conservative mangement] result in [the quickest and fullest recovery]?

Clinical Scenario

A 24 year old man is brought into the Emergency departmment having sustained a laceration over the dorsal aspect of the metacarpophalangeal joint of the left index fingger. You explore the wound and find that there is a 50% laceration of the extensor tendon. You wonder whether this requires repair.

Search Strategy

Medline 1966-03/00 using the OVID interface.
[({exp tendon injuries OR tendon injuries.mp OR exp tendons OR extensor tendon$.mp OR partial tendon laceration$.mp} AND {extensor$ OR dorsal$}) AND {exp casts, surgical OR exp splints OR splint$.mp OR exp surgical procedures, operative OR exp suture techniques OR conservative treatment$.mp OR surgical repair$.mp OR tendon repair.mp}] AND maximally sensitive RCT filter LIMIT to human AND english.

Search Outcome

141 papers found of which none were relevant.

Comment(s)

There is no direct evidence that can assist in answering this question. The trials of partial tendon repair that have been reported all involved flexor tendons. These results cannot be extrapolated to the extensor tendon.

Clinical Bottom Line

Local advice should be followed.