How should I assess for tendon injuries in a patient with a laceration to the hand?

When assessing for tendon injuries in a patient presenting with a hand laceration, begin with a thorough clinical examination focusing on active and passive movements of the fingers and wrist to identify any loss of function or weakness, which may indicate tendon damage NICE NG211. Specifically, test the flexor tendons by asking the patient to flex each finger individually against resistance and the extensor tendons by asking for finger extension; inability or pain during these maneuvers suggests tendon involvement NICE NG211. Palpate along the course of the tendons to detect any gaps, tenderness, or abnormal mobility, which can further support the diagnosis of a tendon injury Cheung et al. 2013. Additionally, assess for associated neurovascular injury, as these often coexist with tendon lacerations and influence management NICE NG211. Document the wound characteristics, including size, depth, and contamination, as these factors affect the likelihood of tendon involvement and urgency of referral Cheung et al. 2013. If tendon injury is suspected, urgent referral to a hand specialist or plastic surgeon is recommended for further assessment and possible surgical repair NICE NG211. Imaging is not routinely required but may be considered if the diagnosis is unclear or to assess for associated fractures NICE NG211.