Objective To explore a modified procedure for reconstruction of extensor tendon insertion.Methods A total of 13 cases of acute avulsion of the extensor tendon insertion were involved.A 'T ' shaped hole was drilled on the base of the distal phalanx perpendicularly by a 1.0 mm K-wire.3-0 tendon suture woven in the terminal extensor tendon was threaded through the drill holes on the distal phalanx to reattach the tendon insertion.DIP joint was fixed at extension by a K-wire which was removed in 6 weeks.A splint was applied to keep the DIP joint in extension till 8 weeks postoperatively when finger extension-flexion movement resumed.A night splint was used till 10 weeks for added protection.Results Primary wound healing was achieved in 12 cases.Wound dehiscence and extensor tendon exposure were seen in one case with severe dorsal skin damage.Flap transfer solved the problem.Postoperative follow-up period ranged from 4 to 30 months.The mallet deformity was corrected.There was no complaint of pain during finger movement.Active motion of involved fingers was satisfactory.According to the upper extremity functional evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association,the results were rated as good in 11 cases,fair in 1 case and poor in 1 case.The overall satisfactory rate was 92.3％.Conclusion The modified procedure of extensor tendon insertion reconstruction is convenient and practical.