Eighty-five patients with extensor zone VI tendon lacerations were randomized to receive standard extensor tendon repair with OrthoWrap® (n = 42) or without OrthoWrap® (n = 43). The primary outcome was extension lag at the metacarpophalangeal joint. Secondary outcomes included MP joint flexion, pain assessed via VAS score, and tendon mobility graded by the Strickland classification. Outcomes were assessed at 1, 2, and 3 months postoperatively. Overall, the results of the study revealed that while both groups improved over time, the OrthoWrap® group had a significantly lower extension lag and a greater proportion of patients with “good” recovery per Strickland criteria. These findings suggest modest benefits of OrthoWrap® in reducing postoperative tendon adhesions, though the clinical relevance of the small improvement remains uncertain.