Treatment of acute flexor tendon injury: zones III-V

Many of the principles of flexor tendon repair and rehabilitation can be applied to zones III-V. Injuries in zones III-V are rarely isolated and neurovascular involvement is common. Because of the often extensive and unknown degree of injury, there should be a low threshold for surgical wound exploration. Primary repair of injured tendons and neurovascular structures is recommended by way of a systematic approach. Good to excellent outcomes in range of motion and tendon function can be expected; however, functional outcomes of associated nerve injuries are varied, with younger patients generally demonstrating the best results (Fig. 2E).