Primary care of flexor tendon injuries

The approach to the acute flexor tendon injury is an area of hand surgery that has seen considerable change in the last 25 years. Direct repair in the early postinjury period, at all levels of injury, is the accepted procedure provided wound conditions permit. The procedures performed along with the tendon repair in zone 2 are based on both clinical experience as well as laboratory evidence, but additions such as sheath closure have not been completely proven to improve the clinical result. At this time, both flexor tendons are repaired in zone 2 and the flexor sheath is repaired. All patients are mobilized in a protected mobilization program. The last modification is probably the chief reason that results from flexor repairs are improving at this time.