A 38-year-old right-hand-dominant electrician attends a GP-led urgent treatment centre 90 minutes after his right hand went through a glass panel at

Question

A 38-year-old right-hand-dominant electrician attends a GP-led urgent treatment centre 90 minutes after his right hand went through a glass panel at work. He has a 2-cm transverse laceration over the dorsum of the hand at the level of the index metacarpophalangeal joint. The wound is clean and bleeding is controlled. Before local anaesthetic, he can actively extend the index finger at the MCP joint, but extension against resistance is substantially weaker and painful compared with the left hand. Sensation, capillary refill and flexor tendon function are normal. Plain radiographs show no fracture or retained radiopaque foreign body. With the MCP joint flexed, careful wound examination identifies a divided extensor tendon. What is the most appropriate management now?

Accepted Answer

Irrigate and dress the wound, apply an extension splint, and arrange same-day assessment by the on-call hand surgery service

Answer

Irrigate and dress the wound, apply an extension splint, and arrange a routine hand clinic appointment

Answer

Prescribe oral co-amoxiclav, apply a simple dressing, and arrange primary care review after 48 hours

Answer

Apply a mallet splint to the distal interphalangeal joint and arrange hand therapy follow-up

Answer

Irrigate and suture the wound, apply a simple dressing, and review wound healing in primary care after 48 hours

Open extensor tendon laceration of the hand — MSRA MCQ