Extensor Treatment Repair Technique Quiz

The correct answer is Both Zone III & IV. In the extensor tendon injury classification system, Zone III refers to injuries located over the proximal interphalangeal (PIP) joint, which is the joint in the middle of the finger. Zone IV injuries occur over the proximal phalanx, the bone in the finger that is closest to the hand. Injuries in both Zone III and Zone IV can affect the extensor tendons that run over these areas, often leading to difficulty in fully straightening the finger or maintaining a stable grip. Treatment for these injuries may involve splinting, hand therapy, or surgical repair, depending on the severity and specific circumstances of the injury. It is important to work closely with a healthcare professional to determine the most appropriate treatment plan for optimal recovery.

The correct answer is "Both Zone I & II." Zone I and Zone II refer to specific regions of the hand and fingers. In this treatment plan, the therapist is addressing nail bed injuries, extensor lag at the DIP joint, and hyper-extension of the PIP joint. These conditions typically occur in Zone I and Zone II, which include the distal phalanx and middle phalanx of the fingers. Therefore, the therapist's treatment plan is appropriate for both Zone I and Zone II.

The specific treatment goals that prevent Boutonnière deformity and prevent secondary contractures are for zones III and IV.

The given treatment plan includes interventions that are typical for both zone III and zone IV. Zone III involves the extensor tendon over the middle phalanx, while zone IV involves the extensor tendon over the proximal phalanx. The treatment plan mentions ROM at 10-14 days, which is typical for zone III, and splinting the PIP joint in extension if lag is noted, which is typical for zone IV. Therefore, the correct answer is both zone III and IV.

The given correct answer is A & C. The indications of an open injury, such as associated fracture requiring internal fixation and the use of a padded dorsal splint that allows PIP joint flexion, suggest that the injury is open. Additionally, the possible treatment of injuries in either zone I or II with MD treatment supports the idea that the injury is open.

The correct answer is "Immobilized approximately 4 weeks with PIP/DIP in extension." This treatment option suggests that the patient's hand and wrist should be immobilized for about 4 weeks with the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints in extension. This is a common treatment approach for fractures or injuries in Zones III and IV, which involve the fingers and hand. Immobilization helps promote proper healing and stability in the affected area.

The correct answer suggests that the possible treatment for Zone VI includes immobilizing the wrist in extension with the metacarpophalangeal (MP) joints in slight flexion for a duration of 4 weeks. This treatment approach aims to stabilize the wrist and promote healing. By immobilizing the wrist in extension, it helps to prevent excessive movement and further damage to the affected area. The slight flexion of the MP joints allows for some functional use of the hand while still providing support to the wrist. This treatment duration of 4 weeks allows sufficient time for the injured tissues to heal properly.

The correct answer is Zone V. In the extensor tendon injury classification system, Zone V refers to injuries located over the dorsum of the hand, which is the back or upper surface of the hand. These injuries often occur due to a crushing force, such as when the hand is caught between two heavy objects or under a heavy falling object. Injuries in Zone V can affect the extensor tendons that run over the dorsum of the hand, causing difficulty in extending the wrist, fingers, or thumb. Treatment for these injuries may include splinting, hand therapy, or surgical repair, depending on the severity and specific circumstances of the injury. Due to the potential complexity and severity of Zone V injuries, it is important to consult with a healthcare professional experienced in treating hand injuries to ensure the best possible outcome.

The given treatment plan includes various activities and exercises that are typically performed in Zone V of hand therapy. Zone V involves the flexor tendon sheath in the palm of the hand and includes the MP and PIP joints. The treatment plan mentioned in the question, such as wrist immobilization in extension for MP/PIP flexion, re-education of extensor digitorum communis, and full AROM flexion/extension of MP at 8 weeks, aligns with the activities typically performed in Zone V. Therefore, the correct answer is Zone V.

The correct answer is Zone VI. In the extensor tendon injury classification system, Zone VI refers to injuries located over the metacarpophalangeal (MP) joint, which is the joint at the base of the finger. Injuries in this zone can affect the extensor tendons that run over the MP joint, resulting in an inability to extend the proximal phalanx, the bone in the finger closest to the hand. This type of injury may lead to difficulty in straightening the finger fully. Treatment for Zone VI injuries may include splinting, hand therapy, or surgical repair, depending on the severity and specific circumstances of the injury.

Contraindications are factors or conditions that make a particular treatment or procedure inadvisable or potentially harmful. Extensor tendon repair is a surgical procedure performed to repair a damaged or severed extensor tendon. In this case, uncomplicated wound closure is not a contraindication for extensor tendon repair. Contrarily, it is a necessary step in the surgical process to ensure proper healing and prevent infection. The other options listed - tendon rupture, infection, edema, and adhesions - are all contraindications as they can interfere with the success of the procedure or increase the risk of complications.

The correct answer is "both A & C". This means that the disruption of the terminal tendon appearing as mallet or drop-tip deformity may or may not be associated with a distal phalanx fracture. Zone A refers to the distal interphalangeal joint, and Zone C refers to the middle phalanx. Therefore, the disruption can occur in both of these zones.

The correct answer is "is a possible MD treatment for injuries in either zone III or IV." Immobilization in neutral or mild hyperextension for 4-6 weeks is a common treatment approach for extensor tendon injuries in Zone III or IV, which are located over the proximal interphalangeal (PIP) joint or proximal phalanx, respectively. Immobilization of the injured finger helps protect the healing tendon and maintain proper positioning during the recovery process. The finger is typically splinted in a neutral or slightly hyperextended position to minimize stress on the healing tendon and promote optimal function after recovery. This treatment approach allows the injured tendon to heal without the need for surgical intervention. After the immobilization period, hand therapy may be recommended to regain range of motion, strength, and flexibility in the finger. It is important to consult with a healthcare professional to determine the most appropriate treatment plan based on the specific circumstances of each patient, as individualized care is essential for optimal recovery.

The correct answer is "Wrist immobilized in extension with MP's in slight flexion." This treatment involves immobilizing the wrist in an extended position while keeping the metacarpophalangeal (MP) joints slightly flexed. This position helps to maintain stability and prevent further injury to the zone V area. Immobilization is typically done for approximately 4 weeks to allow for proper healing.

The three general treatment goals for extensor tendon repair are:

Prevent infection: Ensuring proper wound care and hygiene helps minimize the risk of infection, which can complicate the healing process and lead to poorer outcomes.

Maintain and/or increase range of motion (ROM): Therapeutic exercises and splinting techniques aim to preserve or improve the flexibility and mobility of the injured finger, hand, or wrist. This is crucial for regaining normal function and preventing joint stiffness or contractures.

Full tendon gliding: Achieving smooth and unrestricted gliding of the repaired tendon is essential for optimal function. Therapeutic exercises, scar tissue management, and splinting techniques are employed to promote proper tendon gliding and reduce the risk of adhesions or other complications.

It is important to note that other goals, such as edema reduction and realignment of scar tissue, may also be important components of a comprehensive treatment plan, depending on the specific injury and individual patient needs.