Flexor Tendon Injuries

The flexor tendons arise from the medial aspect of the elbow and travel down the forearm on the ventral or palmar side. At the wrist level, nine flexor tendons (two for each finger and one for the thumb) pass through the carpal tunnel. These tendons then enter each digit in separate tunnels (digital flexor sheath). Inside of each digit, the flexor tendons must glide freely in order to achieve maximum flexion and extension of the digit. In each digit, the flexor tendons are several millimeters beneath the skin, and like the digital nerves, are commonly lacerated with sharp penetrating wounds. Clinical findings of a lacerated flexor tendon within the finger or thumb include an extended posture of the digit, and inability to actively bend the finger or thumb. Treatment involves surgical repair of the lacerated flexor tendon. Special surgical techniques are utilized to best approximate the tendon ends while minimizing scarring. After surgery, therapy is critical to minimize rupture of the flexor tendon repair and scarring.

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