Zone 2 flexor tendon injuries: Venturing into the no man’s land

Abstract

Flexor tendon injuries are seen commonly yet the management protocols are still widely debated. The advances in suture techniques, better understanding of the tendon morphology and its biomechanics have resulted in better outcomes. There has been a trend toward the active mobilization protocols with development of multistrand core suture techniques. Zone 2 injuries remain an enigma for the hand surgeons even today but the outcome results have definitely improved. Biomolecular modulation of tendon repair and tissue engineering are now the upcoming fields for future research. This review article focuses on the current concepts in the management of flexor tendon injuries in zone 2.

Replantation and revascularization of amputated upper limb appendages outcome and predicting the factors influencing the success rates of these procedures in a tertiary hospital: An 8-year retrospective, cross-sectional study

“…Also, many authors agree that amputation in 'no man's land' (zone II, Chen's classification) had the worst functional outcome, due to the complexity of multiple pulleys and complex interweaving of tendons. 24,29,37,39 In this study, age was not a significant predictor, but other authors have reported age to affect the functional outcome after replantation and revascularization. Beris et al 32 and Soucacos 33 observed that although replanted fingers in children have a lower survival rate than adults, their functional results are uniformly superior.…”

“…Also, many authors agree that amputation in ‘no man’s land’ (zone II, Chen’s classification) had the worst functional outcome, due to the complexity of multiple pulleys and complex interweaving of tendons. 24,29,37,39…”

Ordinary PVC feeding tube: A low-cost alternative to silicon rod for staged flexor tendon reconstruction in zone II of hand

“…1 Others started following this idea, and satisfactory results started appearing in literature. 24 However, cost and ready availability (250 US$; Made by Wright Medical Technology, Memphis, Tennessee 38117 USA) of these Hunter silicon rods were the major constraints, more so in the developing countries.…”

Die traumatische Beugesehnendurchtrennung

“…Deshalb bedarf es hierbei einer speziellen chirurgischen Expertise. So kann es aufgrund der besonderen anatomischen Situation sinnvoll sein, auf die Naht einer der beiden Beugesehnen zu verzichten, um die Entstehung von Verklebungen durch zu starkes Sehnenreiben zu vermeiden [6].…”