Extensor Tendon Injuries

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 4 min read
Patient Tools

Read, save, and share this guide

Use these quick tools to make this medical article easier to read, print, save, or share with a family member.

Patient Mode

Understand this article easily

Switch between simple English and easy Bangla patient notes. This is for education and does not replace a doctor consultation.

An extensor tendon injury is a damage to the tissues on the back of the hand and fingers. It can make it hard for you to extend your wrist, open your hand, or straighten your fingers. The inability to perform these functions can severely limit...

For severe symptoms, danger signs, pregnancy, child illness, or sudden worsening, seek urgent medical care.

বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

এই তথ্য শিক্ষা ও সচেতনতার জন্য। এটি ডাক্তারি পরীক্ষা, রোগ নির্ণয় বা প্রেসক্রিপশনের বিকল্প নয়।

Article Summary

An extensor tendon injury is a damage to the tissues on the back of the hand and fingers. It can make it hard for you to extend your wrist, open your hand, or straighten your fingers. The inability to perform these functions can severely limit hand and upper extremity function. Activity that requires repetitive motion of the forearm such as painting, typing, weaving, gardening, lifting...

Key Takeaways

  • This article explains Other Names in simple medical language.
  • This article explains Causes in simple medical language.
  • This article explains Symptoms  in simple medical language.
  • This article explains Diagnosis in simple medical language.
Educational health guideWritten for patient understanding and clinical awareness.
Reviewed content workflowUse writer and reviewer profiles for stronger trust.
Emergency safety firstUrgent warning signs are highlighted below.

Seek urgent medical care if you notice

These warning signs are general safety guidance. Local emergency numbers and clinical judgment should always come first.

  • Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
  • New weakness, severe pain, high fever, or symptoms after a serious injury.
  • Any symptom that feels urgent, unusual, or unsafe for the patient.
1

Emergency now

Use emergency care for severe, sudden, rapidly worsening, or life-threatening symptoms.

2

See a doctor

Book a professional medical evaluation if symptoms persist, worsen, recur often, affect daily activities, or occur in a high-risk patient.

3

Learn safely

Use this article to understand possible causes, tests, treatment options, prevention, and questions to ask your clinician.

Before reading

RX Patient Tools

Use these quick guides before reading the article, or return to them when you need help preparing questions for a doctor.

Start here Choose the right pathway for symptoms, reports, medicines, or urgent warning signs. Disease article roadmap Read this topic step by step: meaning, symptoms, warning signs, diagnosis, treatment, prevention, and follow-up. Treatment planner Prepare questions about treatment choices, benefits, risks, side effects, and follow-up. Family & caregiver guide Organize symptoms, reports, medicines, questions, and follow-up safely. Nutrition & diet guide Prepare food, hydration, supplement, and medicine-timing questions safely. Prevention guide Organize risk factors, protective habits, screening, and warning signs. Recovery guide Prepare a safe plan for activity, rehabilitation, warning signs, and follow-up.
Definition

An extensor tendon injury is a damage to the tissues on the back of the hand and fingers. It can make it hard for you to extend your wrist, open your hand, or straighten your fingers. The inability to perform these functions can severely limit hand and upper extremity function. Activity that requires repetitive motion of the forearm such as painting, typing, weaving, gardening, lifting heavy objects, and sports. Overuse of the forearm muscles. Direct trauma as a fall, work injury, or motor vehicle accident. The extensor carpi radialis brevis (ECRB) and longus, extensor digitorum, extensor digiti minimi, and extensor carpi ulnaris come together to form the common extensor tendon. The extensor carpi radialis brevis is almost always the primary tendon involved.

Cuts that split the tendon may need stitches or surgical repair, but tears caused by jamming injuries are usually treated with splints. Splints stop the healing ends of the tendons from pulling apart and should be worn at all times until the tendon is fully healed. If you tear (rupture) or cut (sever) the tendon anywhere along its route—at the wrist, in the palm of the hand, or along with the finger, you may be unable to bend your finger. If you injure the FDS tendon, you may still be able to bend the finger, but not completely, and bending the finger will be painful

Other Names

  • Extensor tendinopathy

Causes

  • Generally a loss of ability to extend the affected digit, hand, and/or wrist
  • Superficial, susceptible to injury
  • The most common finger is the pointer/ index finger
  • Potential mechanisms are sharp object direct lacerations, burns, blunt trauma, bites, crush injuries, avulsions and deep abrasions
  • Can affect MCPJ and/or PIPJ or DIPJ of hand
  • Zone 1: Traumatic flexion of DIPJ
  • Zone 2: Dorsal laceration or crush injury
  • Zone 5: Fight bite
  • Fractures
    • Phalanx Fractures (Hand)
    • Metacarpal Fractures
      • Boxer’s Fracture
      • Rolando Fracture
      • Bennett Fracture
  • Dislocations
    • Metacarpophalangeal Joint Dislocation
    • Proximal Interphalangeal Joint Dislocation
    • Distal Interphalangeal Joint Dislocation
    • Carpometacarpal Joint Dislocation
  • Tendinopathies
    • Extensor Tendon Injuries (Hand)
    • Central Slip Extensor Tendon Injury
    • Flexor Tendon Injuries (Hand)
    • Boutonniere Deformity
    • Swan Neck Deformity
    • Jersey Finger
    • Mallet Finger
    • Trigger Finger
    • De Quervains Tenosynovitis
  • Ligament Injuries
    • Gamekeepers Thumb (UCL)
    • Radial Collateral Ligament of the Thumb Injury (RCL)
    • Volar Plate Avulsion Injury
  • Neuropathies
    • Wartenberg’s Syndrome
    • Carpal Tunnel Syndrome
    • Guyon Canal Syndrome
  • Arthropathies
    • Carpometacarpal pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।" data-rx-term="arthritis" data-rx-definition="Arthritis means joint inflammation causing pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।">Arthritis
    • Finger pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।" data-rx-term="arthritis" data-rx-definition="Arthritis means joint inflammation causing pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।">Arthritis
    • pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।" data-rx-term="arthritis" data-rx-definition="Arthritis means joint inflammation causing pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।">arthritis: Rheumatoid arthritis is an autoimmune joint disease causing infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation, pain, and swelling. সহজ বাংলা: রোগপ্রতিরোধ ব্যবস্থার ভুল আক্রমণে জয়েন্টের প্রদাহ।" data-rx-term="rheumatoid arthritis" data-rx-definition="Rheumatoid arthritis is an autoimmune joint disease causing inflammation, pain, and swelling. সহজ বাংলা: রোগপ্রতিরোধ ব্যবস্থার ভুল আক্রমণে জয়েন্টের প্রদাহ।">Rheumatoid Arthritis
  • Nail Bed Injuries
    • Nail Bed Lacerations
    • Nail Bed Avulsions
    • Subungual Hematoma
    • Paronychia
    • Felon
  • Pediatric Considerations
    • Proximal Phalanx Avulsion Fracture (Thumb)
    • Middle and Distal Phalanx Avulsion Fracture
  • Other
    • Dupuytrens Contracture

Symptoms 

  • Inability to straighten the fingers or extend the wrist.
  • Pain and swelling in the fingertip.
  • Recent trauma or laceration to the hand.
  • Drooping of the end joint of the finger.

Diagnosis

  • General: Physical Examination Hand
  • Universally present with inability to extend at some point on the dorsal finger, hand, or wrist
  • Inspect for etiology (laceration, crush trauma, overuse, etc)
  • Zone 1: Loss of extensor mechanism at DIPJ (digits 2-4), IJP (thumb)
  • Zone 3: Elson’s Test can help confirm a diagnosis
  • Standard Radiographs Hand
  • Consider ultrasound
  • MRI in complex injuries

Classification

  • Zone 1: DIPJ
    • Injury to terminal extensor tendon distal to or at the DIPJ (digits 2-4) or IPJ (thumb) involving EPL
    • Sequelae: Mallet Finger
  • Zone 2: Middle Phalanx
    • Injury of tendon over middle phalanx (digits 2-4), or proximal phalanx thumb
  • Zone 3: PIPJ
    • Injury over the PIPJ of digit 2-4 leading to Central Slip Injury or MCPJ of thumb involving EPL, EPB
    • Sequelae: Boutonniere Deformity
  • Zone 4: Proximal Phalanx
    • Injury over the proximal phalanx (digits 2-4) or metacarpal of thumb (EPL, EPB)
  • Zone 5: MCPJ
    • Injury over MCPJ of digit (2-4) or CMCJ of thumb (EPL, EPB)
    • Sequelae: Fight Bite, Sagittal band rupture
  • Zone 6: Metacarpals
    • Injury over the metacarpal
    • Sequelae: Increased risk of neurovascular injury
  • Zone 7: Wrist
    • Injury at wrist joint
    • Surgical injury requiring repair of the extensor retinaculum
  • Zone 8: Distal third of the forearm
    • Disruption at the distal forearm
  • Zone 9: Muscle belly rather than tendon injury
    • Sequelae: High risk of neurologic injury, requires surgery

Treatment

Nonoperative

  • Depends on the zone of injury
  • Immobilization if <50% of tendon cut and extensor tendon remains intact
  • DJ extension splint
    • Zone 1 (mallet finger)
  • PIPJ extension splint
    • Zone 3 (central slip if simple)
  • MCPJ extension splint
    • Zone v (closed, uncomplicated sagittal band rupture)

Operative

  • Incision & drainage: Open fracture involving joint, fite bite
  • Repair: tendon laceration >50%
  • Fixation: volar avulsion fracture
  • Reconstruction: tendon repair not possible
  • Central slip reconstruction
Doctor visit helper

Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Rest, drink safe water, and observe symptoms carefully.
  • Keep a written note of symptoms, duration, temperature, medicines already taken, and allergy history.
  • Seek medical care quickly if symptoms are severe, worsening, or unusual for the patient.

OTC medicine safety

  • For mild pain or fever, ask a registered pharmacist or doctor before using common over-the-counter pain/fever medicines.
  • Do not combine multiple pain medicines without advice, especially if you have kidney disease, liver disease, stomach ulcer, asthma, pregnancy, or take blood thinners.
  • Do not give adult medicines to children unless a qualified clinician advises it.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Severe symptoms, confusion, fainting, breathing difficulty, chest pain, severe dehydration, or sudden weakness need urgent medical care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Doctor / qualified healthcare provider
Tests to discuss with doctor
  • Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
  • Relevant blood, urine, imaging, or specialist tests only after clinical assessment
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Extensor Tendon Injuries

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

RX Patient Help

Ask a health question safely

Write your symptom story. A health professional or site editor can review it before any answer is prepared. This box is not for emergency care.

Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

References

Add references, clinical guidelines, textbooks, journal articles, or trusted medical sources here. You can edit this area from the RX Article Professional Blocks panel.

More from this topic
  1. Encephalopathy Due to Prosaposin Deficiency

    DefinitionEncephalopathy due to prosaposin deficiency is an ultra-rare genetic brain disease. It is a lysosomal storage disease in the group called sphingolipidoses. In this disease, a...

    February 26, 2026 • Rx Autoimmune, Genetic and Rare Diseases (A - Z)
  2. Elbow Valgus Deformity

    DefinitionElbow valgus deformity means the forearm points too far away from the body when the elbow is straight. Doctors also call this cubitus valgus. A small...

    February 11, 2026 • Degenerative Bones, Joints, and Spine Care (A - Z)
  3. Varus Elbow Deformity

    DefinitionVarus elbow deformity means that the elbow is bent inward, so the forearm points toward the middle of the body instead of slightly away from it...

    February 11, 2026 • Degenerative Bones, Joints, and Spine Care (A - Z)
  4. Acetabular Avascular Necrosis

    DefinitionAcetabular avascular necrosis means part of the socket of the hip joint (the acetabulum) loses its blood supply, and the bone tissue in that area slowly...

    February 9, 2026 • Degenerative Bones, Joints, and Spine Care (A - Z)
  5. Avascular Necrosis of the Femoral Head

    DefinitionAvascular necrosis of the femoral head means that part of the ball of the hip joint (the femoral head) dies because it does not get enough...

    February 9, 2026 • Degenerative Bones, Joints, and Spine Care (A - Z)
  6. Short Stature-Onychodysplasia

    DefinitionShort stature-onychodysplasia is a very rare genetic condition where a person is very short in height and has poorly formed nails (onychodysplasia). It usually belongs to...

    February 2, 2026 • Rx Autoimmune, Genetic and Rare Diseases (A - Z)
  7. Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

    DefinitionChronic? inflammatory demyelinating polyneuropathy (CIDP) is a long-lasting disease of the peripheral nerves, which are the nerves outside the brain and spinal cord. In CIDP, the...

    January 25, 2026 • Rx Neurology (A - Z)
  8. Charcot-Marie-Tooth Neuropathy Type 1 (CMT1)

    DefinitionCharcot-Marie-Tooth neuropathy? type 1 (CMT1) is a lifelong, inherited nerve disease that mainly damages the “covering” (myelin) of the long nerves in the arms and legs....

    January 6, 2026 • Rx Autoimmune, Genetic and Rare Diseases (A - Z)
  9. Charcot-Marie-Tooth Disease Demyelinating, Type 1G (CMT1G)

    DefinitionCharcot-Marie-Tooth disease, demyelinating, type 1G (often written CMT1G) is a rare, inherited nerve disease that slowly damages the long nerves in the arms and legs. These...

    January 5, 2026 • Rx Autoimmune, Genetic and Rare Diseases (A - Z)
  10. Distal Neurogenic Amyotrophy

    DefinitionDistal neurogenic amyotrophy is a general medical phrase that means nerve-related muscle wasting that mainly affects the far (distal) parts of the arms and/or legs, such...

    January 5, 2026 • Rx Autoimmune, Genetic and Rare Diseases (A - Z)