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Flexor Tendon Injuries (Hand)

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Other Names

  • Flexor tendon laceration

Background

  • Classified anatomically into zones
  • Relatively rare

Pathophysiology


Risk Factors

  • Unknown

Differential Diagnosis

Differential Diagnosis Finger & Hand


Differential Diagnosis Wrist


Clinical Features

  • General: Physical Examination Hand
  • Universally present with loss of flexion distal to the lesion
  • Inspection
    • Cascade Sign can be used to help evaluate for rotational deformity
  • Range of motion
    • Passive and active evaluation
  • Neurovascular injury

Evaluation


Classification

  • Flexor tendon injuries are divided into zones
  • Zone 1
  • Zone 2
    • Distribution: FDS insertion to A1 pulley
    • Pathology: Can injury both FDS and FDP
  • Zone 3
    • Distribution: A1 pulley to distal carpal ligamnt
    • Pathology: Often associated with neurovascular injury
  • Zone 4
  • Zone 5
    • Distribution: Carpal tunnel to forearm
    • Pathology: Often associated with neurovascular injury
  • Thumb
    • T1
    • T2
    • T3

Management

Nonoperative

  • Flexion important for function, high risk of morbidity
  • Nonoperative management essentially limited to partial lacerations < 60% of tendon width

Operative

  • Flexor tendon repair
  • Flexor tendon reconstruction
  • FDS transfer to thumb

Return to Play

  • Needs to be updated

Complications


See Also


References


Created by:
John Kiel on 20 August 2019 23:15:38
Authors:
Last edited:
28 October 2020 13:51:29
Categories: