PURPOSE: We analyzed the results of treatment of dislocation of the extensor tendons over the metacarpophalangeal joints. MATERIALS AND METHODS: Thirteen patients who had received treatment for dislocation of the extensor tendons over the metacarpophalangeal joint were reviewed. Ten patients had traumatic dislocations, two had spontaneous dislocations, and one had congenital dislocation. The long finger was most frequently affected. The other fingers were affected almost equally. Displacement of the extensor tendon always occurred in the ulnar direction in the long and ring fingers. The index and little fingers exhibited different patterns of dislocation. RESULTS: Nonsurgical treatment was undertaken in two cases. Surgery was performed in 11 cases. No recurrent dislocations were reported in any of the patients. Conculsions: Based on our experience, patients seen within 2 weeks of injury initially should be treated with splinting of the involved metacarpophalangeal joint. Chronic dislocations should be treated with a primary repair of the defect in the sagittal band. When the sagittal band is absent or deficient, the tendon must be stabilized using a loop procedure with a tendon slip.