Background; Extensor tendon apparatus injuries of the hand, wrist, and forearm are common in trauma practice, yet early functional recovery differs noticeably across anatomical zones. In many patients, the limiting factor is not tendon continuity alone, but stiffness, adhesions, and subtle imbalance that emerges during the first few weeks after repair. Objectives; To describe injury patterns by zone, mechanism, and tendon involvement, and to evaluate early post-operative functional outcome using Miller’s criteria. Methods; A longitudinal prospective study was conducted from June 2024 to November 2025 among patients undergoing surgical repair for extensor tendon apparatus injuries involving the hand, wrist, or forearm (n = 85). Recorded variables included demographics, hand dominance, mechanism of injury, anatomical zone (I–IX), tendon(s) involved, time to presentation, and early complications. Functional outcome at post-operative day 14 was graded using Miller’s criteria. Associations were tested using chi-square where appropriate with a significance threshold of p < 0.05. Results; Mean age was 32.4 ± 11.6 years; 72.9% were male, and 58.8% involved the dominant hand. The common mechanisms were glass cuts (34.1%), machinery injuries (28.2%), knife injuries (17.6%), and crush injuries (12.9%). Zone VI injuries predominated (31.8%), followed by Zone V (18.8%) and Zone VII (12.9%). The most frequently involved tendon group was extensor digitorum communis (52.9%), followed by extensor pollicis longus (18.8%). At day 14, outcomes were Excellent 21.2%, Good 45.9%, Fair 23.5%, and Poor 9.4%. Distal zones (I–III) showed a higher Fair/Poor proportion than mid-zones (V–VII) (45.0% vs 26.2%, p = 0.03). Presentation after 24 hours was associated with poorer grades (18.2% vs 6.1%, p = 0.04). Early complications included stiffness/adhesions (14.1%), superficial infection (5.9%), and rerupture (2.4%). Conclusion; Extensor tendon injuries clustered in Zone VI and were predominantly sharp or machinery-related. Distal zones and delayed presentation were associated with poorer early function, supporting zone-stratified counselling and rehabilitation planning from the first follow-up