hand flexor repair basics

1. Global Hand
Teaching Programme
Module 2.2
Flexor tendon repair
Tiko
Abdul

2. Module 2.2
Flexor Tendon Repair
Objectives
1. Describes the different zones of flexor tendon injury
2. Appreciate the issues around zone two flexor tendon injury and the current thinking on
repair principles
3. Describe the classification of zone 1 FDP injuries and implications for management

3. Flexor Tendon Zones

4. Exposure

5. Repair Technique
Modified Kessler Adelaide

6. Epi-tendinous Stitch
Start at back wall especially in
Zone II

7. Zone 1 FDP Injuries

8. Zone 1 FDP Repair

9. Immobilisation Post Repair

10. Case 1
• A 19 year old boy presents with a laceration on
the right palm from a knife attack which was 1
hour ago.
1. Describe the injury you see?
2. How will you manage this condition?
3. On exploration you find that both FDS and FDP
tendons have been divided just proximal to the A1
pulley. What zone of injury is this and how will you
go about your repair?
4. How will you rehabilitate the patient after repair?
bssh.ac.uk

11. Case 2
• Your next patient is a 40 year old chef who
slipped cutting vegetables, plunging the knife
into his little finger at the level of the PIPJ.
1. Describe the injury you see?
2. What structures are at risk and how do you
examine them?
4. What zone is a flexor tendon injury likely to be in?
Does the position of the finger at time of injury
make any difference?
5. Discuss techniques and controversies of flexor
tendon repair. In this zone.
bssh.ac.uk

12. Case 3
• A patient presents 1 year after FDP repair of
the right middle finger, complaining of weak
grip and difficulty flexing the adjacent fingers.
1. Describe what you see.
2. What is this phenomenon called?
3. Why does it occur?
4. What treatment options may be considered?
bssh.ac.uk

13. Questions?
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14. Teaching feedback link m2.2
https://s.surveyplanet.com/fd3jhc9p