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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2023
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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 |
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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 |
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