My son injured the tendon between his middle knuckle and the one where the finger joins the hand. He couldn't stretch his finger out any more. One doctor said he needed splinting, another said he needed surgery right away. Why the huge difference in treatment style?
Extensor tendon injuries, injury to a tendon that allows you to extend your hand or finger, are not always easy to diagnose and there is not yet a lot of agreement on how best to treat them.
Currently, doctors are most often treating tendon injuries that are not cut through more than 50 percent with splinting first, before attempting surgery. This less invasive method has fewer potential complications, although some doctors feel that by immobilizing the finger for so long, you could be risking stiffness in the joint and difficulty with full bending and stretching. Tendon damage that is more than 50 percent through the tendon does call for surgery so the tendon can be repaired properly.
The doctors may have differing opinions because of studies they have read or personal successes with their treatment choice. To make the right, informed decision for your son, you need to speak with the doctors to discover their rationale.
Jonas L. Matzon, MD, and David J. Bozentka, MD. Extensor Tendon Injuries. In The Journal of Hand Surgery. May 2010. Vol. 35. No. 5. Pp. 854-861.
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