Management of Flexor Tendon Injuries in Hand

Ahmad, Tawheed; Jan, Summaira; Rashid, Saima

doi:10.5772/intechopen.83483

Cited by 3 publications

(3 citation statements)

References 36 publications

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“…However, a crush injury could result in damage to the carpal tunnel flexor tendons and the median nerve. Zone V injuries can result in damage to the ulnar and radial arteries, ulnar and median nerves, as well as multiple flexor tendons [ 56 ]. Flexor tendon tenosynovitis can occasionally be seen in the setting of inflammatory arthritis or in athletes with overuse injuries, such as those who play racquet sports or golf [ 26 ].…”

Section: Internal Derangement Of the Wristmentioning

confidence: 99%

Magnetic resonance imaging of the wrist and hand

Vassa¹,

Garg²,

Omar³

2020

Pol J Radiol

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The anatomy of the wrist and hand is complex and contains numerous small structures. Magnetic resonance imaging (MRI) is often an ideal imaging modality in the assessment of various traumatic and pathologic conditions of this region, and it is frequently performed after initial radiographs. In this manuscript we describe the normal anatomy, imaging techniques, and MRI findings of various traumatic and pathologic conditions of the wrist and hand including occult fractures, osteonecrosis, ligamentous and tendon injuries, and entrapment neuropathies.

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Section: Internal Derangement Of the Wristmentioning

confidence: 99%

Magnetic resonance imaging of the wrist and hand

Vassa¹,

Garg²,

Omar³

2020

Pol J Radiol

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“…We included all patients over 18 years old with Zone I or II injuries who had primary flexor tendon repairs at the study hospital during the study period. 11 Zone I was defined as distal to the flexor digitorum superficialis (FDS) insertion and Zone II was defined as between FDS insertion and distal palmar crease/proximal A1 pulley (Fig. 1).…”

Section: Participant Selection Criteriamentioning

confidence: 99%

Management and outcomes of flexor tendon repairs at a peripheral hospital: a New Zealand case series study

Zhou

Krishna

Sharplin

2021

ANZ Journal of Surgery

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Background: Current evidence for flexor tendon repair management and outcomes performed at peripheral centres is unclear. Most studies are based on evidence from specialist hand centres. This study evaluated a peripheral hospital in New Zealand; where all flexor tendon repairs were performed by a generalist Orthopaedic service. The purpose of the study was to benchmark management and outcomes from a peripheral hospital in comparison to international standards. Methods: A retrospective single-centre consecutive case series of Zones I and II flexor tendon repairs was extracted between 1 January 2014 and 1 January 2018. Medical records were used to evaluate management and outcomes of repairs. Hand therapy notes were used to evaluate rehabilitation protocols provided. The primary objective was to measure re-rupture and re-operation rates. Secondary objectives included auditing operative management and hand therapy compliance. Results: Forty-six patients (76 tendon repairs) were included in our final analysis. Mean follow up time to last clinical appointment was 11.8 weeks, and to last patient episode was 4.9 years. Most patients received timely surgery with a four-core repair using 3-0 or larger suture. All hand therapy followed a controlled active motion protocol. The re-operation rate was 19.6% (P = <0.05) and the re-rupture rate was 8.7% (P = 0.28). Conclusions: Most flexor tendon injuries at this peripheral centre were managed according to international standards. However, high complication rates including re-operation and rerupture occurred. Due to a lack of local comparison studies, confounding factors cannot be excluded as a contributor for these results.

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“…In cut wounds involving the flexor zone II of the hand, it should be not surprising to find that the deep tendon is completely lacerated without an injury to the superficial one. Although deep cut wounds in the flexor zone II usually involve both tendons [ 14 ], laceration of the deep tendon (FDP) without affecting the superficial one (FDS) can rarely occur. This is because the superficial tendon bifurcates and becomes attached to the middle phalanx, allowing the deep tendon to pass underneath it and become attached to the distal phalanx.…”

Section: Introductionmentioning

confidence: 99%

Isolated Flexor Digitorum Profundus Injuries in Flexor Zone II of the Hand: A Report of Five Cases

Alkandari¹,

Alawadhi²,

Alawadhi³

et al. 2023

Cureus

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Injuries of the hand's flexor tendons carry a poor prognosis, mainly if they are in zone II (also called 'the critical zone' or 'no man's land'). The superficial tendon in this zone ends by bifurcating and attaching to the sides of the middle phalanx, exposing the deep tendon that attaches to the distal phalanx. Thus, trauma to this zone may result in a complete cut to the deep tendon while the superficial one remains intact. The lacerated tendon, in turn, would be retracted proximally to the palm making it difficult to be found during wound exploration. The complex anatomy of the hand, particularly that of the flexor zones, may contribute to the misdiagnosis of a tendon injury. We report five cases of an isolated cut of the flexor digitorum profundus (FDP) tendon after traumatic injury to the flexor zone II of the hand. The mechanism of injury of each case is reported together with a clinical approach that guides ED physicians toward diagnosing flexor tendon injuries in hand. In cut wounds involving the flexor zone II of the hand, it should be not surprising to find that the deep tendon (FDP) is completely lacerated without an injury to the superficial one (FDS). Therefore, we conclude that a systematic examination approach for traumatic hand injuries is essential to ensure the proper assessment. Understanding the mechanism of injury, performing a systemic examination approach, and having basic anatomical knowledge of flexor tendons of the hand are essential to identifying tendon injuries, anticipating complications, and providing adequate healthcare.

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Management of Flexor Tendon Injuries in Hand

Cited by 3 publications

References 36 publications

Magnetic resonance imaging of the wrist and hand

Magnetic resonance imaging of the wrist and hand

Management and outcomes of flexor tendon repairs at a peripheral hospital: a New Zealand case series study

Isolated Flexor Digitorum Profundus Injuries in Flexor Zone II of the Hand: A Report of Five Cases

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