An Overview of the Extensor Tendons
The extensor tendons are the tendons on top of the ankle and the foot. When they work, they cause the foot, toes and ankle to move in the upward direction. These tendons are extremely important when walking and standing because without them, you would have a foot drop and the foot would drag along the floor.
Some examples of extensor tendons include:
- Tibialis anterior (this is the major tendon that moves the whole foot up at the ankle joint)
- Extensor hallucis longus (this is the tendon that moves the big toe up)
- Extensor digitorum longus (these are four tendons that attach to the smaller toes to move them up)
A patient drops a knife on his foot while cooking!
I recently had a patient who dropped a very sharp knife on the top of his foot while he was cooking. There were multiple open wounds on the top of the foot and unfortunately the small tendon that goes into the smallest toe (the fifth digit) was completely ruptured by the knife.
The fifth toe would not move in the upward direction and it was dragging under his foot while he walked. Take a look at the picture below. The fifth toe is not straight. In fact, the toe was sitting directly under the foot and dragging as the patient walked.
This was obvious with examination of the foot but confirmed with an MRI.
Treatment for a Laceration to the Extensor Tendons
Since the patient was young, extremely active and required full use of his foot the laceration was repaired with surgery. Before surgery the toe was sitting below the foot.
A new incision was needed to access the two ends of the tendon and they were easily found. The ends were cleaned up and sutured back together with strong suture that does not dissolve. This ensures there is a really strong repair.
We treat foot and ankle trauma
Injuries are very common to the foot and ankle whether this is a sprain of the ankle, crush injury of the foot, a metatarsal fracture, toe fracture, or tendon laceration.
In the case of a knife injury, you should immediately go to the emergency room for evaluation to determine the extent of injury. You may require surgery to retain full function of the foot and ankle, antibiotics and a tetanus booster.