Cargando…

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

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Alkandari, Ahmed F, Alawadhi, Abrar, Alawadhi, Fatma A, Renno, Waleed M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9975286/
https://www.ncbi.nlm.nih.gov/pubmed/36874729
http://dx.doi.org/10.7759/cureus.34360
_version_ 1784898843475705856
author Alkandari, Ahmed F
Alawadhi, Abrar
Alawadhi, Fatma A
Renno, Waleed M
author_facet Alkandari, Ahmed F
Alawadhi, Abrar
Alawadhi, Fatma A
Renno, Waleed M
author_sort Alkandari, Ahmed F
collection PubMed
description 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.
format Online
Article
Text
id pubmed-9975286
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-99752862023-03-02 Isolated Flexor Digitorum Profundus Injuries in Flexor Zone II of the Hand: A Report of Five Cases Alkandari, Ahmed F Alawadhi, Abrar Alawadhi, Fatma A Renno, Waleed M Cureus Emergency Medicine 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. Cureus 2023-01-29 /pmc/articles/PMC9975286/ /pubmed/36874729 http://dx.doi.org/10.7759/cureus.34360 Text en Copyright © 2023, Alkandari et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Alkandari, Ahmed F
Alawadhi, Abrar
Alawadhi, Fatma A
Renno, Waleed M
Isolated Flexor Digitorum Profundus Injuries in Flexor Zone II of the Hand: A Report of Five Cases
title Isolated Flexor Digitorum Profundus Injuries in Flexor Zone II of the Hand: A Report of Five Cases
title_full Isolated Flexor Digitorum Profundus Injuries in Flexor Zone II of the Hand: A Report of Five Cases
title_fullStr Isolated Flexor Digitorum Profundus Injuries in Flexor Zone II of the Hand: A Report of Five Cases
title_full_unstemmed Isolated Flexor Digitorum Profundus Injuries in Flexor Zone II of the Hand: A Report of Five Cases
title_short Isolated Flexor Digitorum Profundus Injuries in Flexor Zone II of the Hand: A Report of Five Cases
title_sort isolated flexor digitorum profundus injuries in flexor zone ii of the hand: a report of five cases
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9975286/
https://www.ncbi.nlm.nih.gov/pubmed/36874729
http://dx.doi.org/10.7759/cureus.34360
work_keys_str_mv AT alkandariahmedf isolatedflexordigitorumprofundusinjuriesinflexorzoneiiofthehandareportoffivecases
AT alawadhiabrar isolatedflexordigitorumprofundusinjuriesinflexorzoneiiofthehandareportoffivecases
AT alawadhifatmaa isolatedflexordigitorumprofundusinjuriesinflexorzoneiiofthehandareportoffivecases
AT rennowaleedm isolatedflexordigitorumprofundusinjuriesinflexorzoneiiofthehandareportoffivecases