Extensor tondon lacerations are much more common than flexor tendon injuries. The outcome of this lesions depends on mamy factors including severity of initial trauma, coexisting lesions, of the hand, site of the laceration, experience of the surgeon, and post operative rehabilitation. The aim of this prospective study was to review our results of primary extensor tendon repair with regard to the zone of injury.

During a period of 28 months, 32 patients with open extensor tendon laccerations were repaired by modified kessler technique using 4-0 nonabsorbable suture. After tendon repair, immobilization with a volar splint was applied for 4-weeks and physiotherapy was carried out. Patients were followed–up for a mean of 12 months. we used the 5 extensor tendon zones and results were assesed using Miller’s rating system. Patents with closed tendon ruptures or concomitant hand fracture were excluded from the study.

Seventy two extensor tendons were repaired. The mean age of patients was 24.6 years (17–46 y). Excellent and good resalts were obtained as the follows: in zone 5(88/4%), zone 3 (84%), zone 2(55.5%), zone 4(42.7%), zone 1(40%). Results were poor in zone 4(42.8%), zone 1(40%), zone 2(22.2%), zone 3(4%), and zone 5(3.9%). No in fection was seen.

We found a strong correlation between the site of the repair and outcome. More excellent and good results were obtained when the repair was performed distal to the extensor retinaculum (Zone 3), and above the wrist (Zone 5). Unsatisfactory results were seen when the tendon repair was done at or near DIP joint (zone 1), in the region of complex extensor mechanism (zone 2) or beneth the extensor retinaculum (zone 4). We cocluded the anatomic location of tendon repair has an important effect in outcome.