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Extensor Tendon Subluxation


The extensor tendons are continuations of the muscles that attach to the bone, and are like ropes that are responsible or extending your fingers.  They usually sit centered on top of the knuckles and are held in this central position by tissues called the sagittal bands.  Extensor tendon subluxation is where these tendons fall off of their centered position into the valley between the metacarpal heads.  This can be caused by trauma, most commonly punching or falling onto your hands while they are in a fist-like position.  It can also occur from inflammatory conditions such as Rheumatoid Arthritis.


Extensor tendon subluxation can be asymptomatic in some patients.  In other patients, however, it can cause the inability to fully extend the finger after making a fist and cause pain overlying the knuckles.  Patients can often feel their extensor tendon clicking or popping back and forth off of the knuckle.


Diagnostic Testing

Dr. Steven Lee will typically diagnose your extensor tendon subluxation clinically.  However, an x-ray and other radiologic studies may be obtained if the diagnosis is in question or to rule out other disorders.  If there is a concern for an inflammatory cause, blood tests and/or a Rheumatologic consultation may be suggested.


Treatment Options

Dr. Steven Lee employs many treatment options depending on the severity of the disease and the patient's symptomatic and functional disability.  In patients who have acutely traumatized their extensor tendon, Dr. Steven Lee may suggest wearing a splint to keep the fingers in a fully extended position for 4-6 weeks followed by progressive weaning of the splint and hand therapy.

In patients who have chronic extensor tendon subluxation or who have failed non-operative treatment, surgical treatment may be suggested.  The surgery consists of realignment of the tendon so that it is centered over the knuckle.  The actual surgery is relatively simple, and is usually done as an outpatient.  

Learn more about scheduling surgery.


Recovery Expectations

Post-operative care typically consists of splinting for up to 4-6 weeks followed by hand therapy for up to 2-3 months.  It is important during the immediate post-operative period to keep the hand elevated above the level of the heart and to keep the dressing clean and especially dry.

Immediate Post-Operative Instructions

Please refer to the following pages for more information:



*It is important to note that all of the information above is not specific to anyone and is subject to change based on many different factors including but not limited to individual patient, diagnosis, and treatment specific variables.  It is provided as an educational service and is not intended to serve as medical advice.  Anyone seeking specific orthopedic advice or assistance should consult Dr. Steven Lee or an orthopedic specialist of your choice.

*Dr. Steven Lee is a board certified orthopedic surgeon and is double fellowship trained in the areas of Hand and Upper Extremity Surgery, and Sports Medicine. He has offices in New York City, Scarsdale, and Westbury Long Island.  

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