Zone VI injuries frequently involve tendon damage due to their superficial site over the dorsum of the hand. When assessing extension, care is advised because, if the laceration is proximal to the junctura tendinae, the patient may be able to extend the involved MCPJ despite a ruptured tendon. Weak extensor forces are transmitted to the junctura from adjacent extensor tendons.
ED management may include a wound exploration to identify any tendon injury. Confirmed tendon injuries require surgical repair for which hand surgery referral is required.