What are the flexor tendon zones?
Anatomy of flexor tendons. There are two flexor tendons for each digit- flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP).
Why is flexor tendon Zone 2 called No Man’s Land?
Bunnell, in 1918, coined the term “no man’s land” to describe zone 2 in the hand because at that time it was felt that no man should attempt repair within this zone.
How many zones are in the extensor tendon?
Verdan defined eight zones- four odd numbered zones overlying each of the joints and four even numbered zones overlying the intervening tendon segments, increasing from distal to proximal.
How many flexor zones are present in the hand?
Flexor tendons of hand are divided into five zones: Zone I: Extends from finger top to insertion of flexor digitorum superficialis. Zone II: This extends from insertion of flexor digitorum superficialis up to distal palmar crease. Zone III: Extends from distal palmar crease up to flexor retinaculum.
What is Zone II in the flexor tendon zone classification?
|Flexor Zones of Injury|
|II||FDS insertion to distal palmar crease/proximal A1 pulley|
|III||Palm (A1 pulley to distal aspect of carpal ligament)|
Where is Zone 5 of the hand?
Zone V extends from the proximal border of the transverse carpal ligament to the musculo tendinous junction in the proximal part of the forearm. Flexor tendon lacerations in the forearm are frequently associated with laceration of the nerve and artery which further compromise the function of the hand.
Why are hands divided into zones?
There are 5 Flexor and 9 Extensor Zones of the Hand. They are used to describe the location of a tendon injury, guide post-operative therapy and predict prognosis.
What tendons are in Zone 2 of the hand?
We hypothesize that a region of the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) tendons in zone 2 exists that, when involved in a laceration repair, will reliably catch on the A2 pulley after surgery.
Where is Zone 2 of the thumb?
Zone II extends from the middle of the middle phalanx to distal palmar crease. It contains both flexor tendon superficialis and flexor tendon profundus. Proximal to zone II, the flexor digitorum superficialis tendons lie superficial to the FDP tendons.
What is the anatomy of a flexor tendon repair?
Anatomical guide to pertinent structures. A flexor tendon repair can be described by its eponymous name, the number of core strands, configuration, knot location, and epitendinous suture. There are a large number of variables deciding on your suture technique for flexor tendon injury repairs.
What is the zone classification of flexor tendon injuries?
The zone classification of flexor tendon injuries divides injuries into five zones based on anatomical location. It is the most widely used flexor tendon injury classification system (c. 2007) 1. Flexor tendon injuries were classified into five zones by Kleinart and Verdan in 1983 1,4: The thumb has its own zones 4: 1. William R. Walsh.
How many strands of stitches are in a flexor tendon repair?
Core sutures can range from 2-8 strands. This is a surgical decision. 4. Epitendinous repairs increase strength and reduce friction. 5. Knots are the weakest part of the tendon repair There are 3 common ways to describe flexor tendon injury repairs. Zone of injury: Zone 1-5 as described by Kleinert 1 & Verdan 2.
How much lidocaine do you give for flexor tendon repair?
Wide-awake flexor tendon repair anesthesia performed under tumescent local anesthesia using lidocaine with epinephrine dosing usually epinephrine 1:100,000 and 7mg/kg lidocaine. from 1:400,000 to 1:1000 is safe. if < 50cc is needed 1% lidocaine with 1:100,000 epi for a 70kg person.