Current methods and biomechanics of extensor tendon repairs.

Extensor tendon injuries occur frequently. An in-depth understanding of the intricate anatomy of the extensor mechanism is necessary to guide management. Careful counseling is helpful in ensuring patient compliance and optimal outcomes for nonoperative and surgical treatments. For distal lacerations in Zones II-V, we prefer the running-interlocked horizontal mattress technique. Prolonged immobilization or inadvertent shortening of the extensor mechanism can create the unintended consequence of joint stiffness. While clinical outcomes have improved with modern repairs and rehabilitation, patients should be advised that a slight extensor lag may persist and full flexion may not be possible despite seemingly successful treatment.