Flexor Zone 5 cut injuries: emergency management and outcome

Area of Science:

• Hand surgery
• Traumatology
• Orthopedic surgery

Background:

• Flexor Zone 5 injuries in the hand present unique challenges for emergency management.
• Accurate assessment and timely intervention are crucial for optimal patient outcomes.

Purpose of the Study:

• To determine the outcome of emergency management for cut injuries in Flexor Zone 5 of the hand.
• To devise a protocol for the effective emergency management of these injuries.

Main Methods:

• A descriptive study was conducted over 4 years (January 2009 - March 2013) at a hospital in Lahore, Pakistan.
• Included patients >12 years with sharp Flexor Zone 5 injuries within 12 hours, excluding skeletal trauma.
• Evaluated outcomes using Strickland's formula for range of motion, muscle power assessment, and nerve repair scoring (Tinnel's sign, electrophysiology, sensory perception).

Main Results:

• The study included 31 patients (27 years average age), with most injuries being accidental.
• Commonly injured structures included flexor tendons, ulnar artery, and ulnar nerve.
• Good recovery of long tendons and comparable nerve repair outcomes were observed, with no re-explorations needed for ischemia.

Conclusions:

• Early and technically precise evaluation, exploration, and repair of Flexor Zone 5 tendon injuries yield favorable functional and technical results.
• A structured protocol for emergency management can improve outcomes for these specific hand injuries.