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Updated: Jan 8, 2026
Murine Flexor Tendon Injury and Repair Surgery
Published on: September 19, 2016
Selective FDP repair in zone 2B flexor tendon injuries: a better outcome by doing less?
1Department of Orthopedics and Traumatology, Private Medline Adana Hospital, Adana, Turkiye.
Purpose:
Zone 2B flexor tendon injuries present unique surgical challenges, with ongoing debate regarding optimal management of concurrent flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) ruptures. This study compared functional outcomes between isolated FDP repair versus combined FDS-FDP repair in Zone 2B injuries..
Methods:
We retrospectively analyzed 69 patients (97 fingers) with complete Zone 2B flexor tendon injuries between January 2017 and December 2020. Group 1 underwent isolated FDP repair (35 patients, 49 fingers) while Group 2 received combined FDS-FDP repair (34 patients, 48 fingers). Primary outcomes included total active motion (TAM), deformity rates, and functional assessment using Tang grading at 12-month follow-up.
Results:
Group 1 demonstrated significantly superior outcomes across multiple parameters. Deformity occurrence was markedly lower in Group 1 (28.6% vs 68.8%, p<0.001), with reduced deformity angles (p=0.008). Total active motion was significantly higher in Group 1 (p<0.001), alongside improved TAM percentages (p=0.033) and total passive motion (p<0.001). While not statistically significant, Group 1 showed trends toward higher rates of excellent outcomes (55.1% vs 33.3%) and reduced reoperation rates (8.2% vs 16.7%).
Conclusion:
Isolated FDP repair in Zone 2B injuries yields superior functional outcomes with significantly reduced deformity rates compared to combined tendon repair. When FDS repair compromises FDP gliding, selective FDS excision appears beneficial. This supports the selective excision of FDS when FDP gliding is compromised, streamlining surgical strategy in this anatomically constrained zone.
