Orthopaedic MD

In addition to having technical expertise, experienced hand surgeons must have precise knowledge of flexor tendon anatomy to guide appropriate treatment of injuries to the flexor tendon system. The flexor tendon system consists of the flexor muscles in the volar compartment of the forearm, their tendinous extensions, and a specialized synovial lining.
Synonyms and related keywords: flexor tendon system, flexor pulley system, flexor sheath, retinacular sheath, trigger finger, stenosing tenosynovitis
Bates, Laurencin & Chang 2007

This chapter is designed to assist the surgeon in all aspects of care of flexor tendon injuries. After a brief historical perspective, a presentation of flexor tendon anatomy and physiology ensues. Diagnosis and classification of flexor tendon injuries are then followed by a description of past and present surgical and post-operative management techniques, expected complications, and outcomes of flexor tendon surgery. The reader will gain an appreciation for the management challenges associated with flexor tendon injuries, but will be armed with a practical knowledge base for their successful treatment.
Authors -John Gray Seiler III, M.D. Emory University Atlanta, GA 30309-1299
Evander F. Fogle, MD Naval Hospital, Guantanamo Bay, Cuba FPO AE 09589-1000

Injuries to the flexor tendons of the hand are common. Each specific movement of the hand relies on the finely tuned biomechanical interplay of intrinsic and extrinsic musculotendinous forces. Considering the hand's role in labor, entertainment, art, literature, and passion, hand surgeons should fully define the normal and pathologic boundaries in each patient examined. With injuries that involve flexor tendons, fully defining the pathology is especially important. In this article, the management of the flexor tendon injuries is addressed specifically, with emphasis on history, physical examination, surgical repair, and rehabilitation.
Synonyms and related keywords: hand injury, flexor tendon injury, finger injury, Jersey finger, flexor tendon rupture, Kienböck disease, scaphoid nonunion, hamate fracture, Colles fracture
Neumeister, Wilhelmi & Bueno 2007

Synonyms and related keywords: flexor tendon injuries, flexor tendon, tendon laceration, flexor tendon laceration, fibrous flexor sheath, tendon sheath, sheath reconstruction, multistrand repair, tensile strength, flexor tendon surgery, flexor laceration, tendon flexor
Author: D Glynn Bolitho, MD

Posted 07/01/2007 TB Thien Introduction Date of Most Recent Substantive Amendment: 2004 06 01 Background Postoperative rehabilitation of the flexor tendons in the hand consists of a short period of immobilisation while pain and swelling diminish, followed by progressive mobilisation to maximize the range of motion of the affected fingers. By altering the time of immobilisation and the manner of subsequent mobilisation different rehabilitation regimes are created.
Authors' conclusions Controlled mobilisation regimens are widely employed in rehabilitation after flexor tendon repair in the hand. This review found insufficient evidence from randomised controlled trials to define the best mobilisation strategy.
Cochrane Rev Abstract. 2007