An incision was made in her old laceration, with radial and ulnar axial extensions, to allow for exposure. Subcutaneous flaps were raised. It was quite clear that there was complete laceration of the extensor tendon, with a fair amount of early inflammatory tissue formation. Inflammatory tissue was appreciated, and dissection was undertaken. The laceration led to laceration of the extensor indicis proprius tendon, the extensor digitorum communis tendon, and the dorsal capsule of the metacarpophalangeal joint, with obvious exposure of the joint. The wound is then irrigated copiously with normal saline. The dorsal joint capsule was closed using 4-0 Vicryl figure-of-eight sutures. The extensor indicis proprius and extensor digitorum communis tendon were reapproximated using 2-0 Ethibond sutures in a core Kessler type fashion, with a bolstering horizontal mattress suture, giving a total of 4 core strand repair to each tendon. Tourniquet was then released, with a total tourniquet time of approximately 20 minutes. Hemostasis was obtained using bipolar electrocautery. The wounds were irrigated with normal saline, and the incision was closed using a series of interrupted 4-0 nylon horizontal mattress sutures. A dressing was applied, consisting of Xeroform, dry gauze, and a volar splint, placing the wrist and fingers in full extension. This was secured with an Ace wrap. She was awakened from anesthesia, transferred to the hospital bed, and taken to the postanesthesia care unit in stable condition.
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