Acute traumatic tendon ruptures nearly always occur at the point of tendon insertion. Mallet finger, boutonniere finger, and profundus avulsion injuries account for the great majority of tendon ruptures. These may occur as pure soft tissue injuries or may be associated with avulsion fractures. Attritional ruptures may occur at sites where tendons pass over fracture lines, and interestingly are more common in nondisplaced than displaced fractures. The most common posttraumatic attritional ruptures are extensor pollicis longus rupture after a distal radius fracture and small finger flexor digitorum profundus rupture after a hook of hamate fracture.