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Self-Inflicted Wrist Injuries in Flexor Tendon Zone V: Clinical Patterns, Management Strategies, and Outcomes
María F Hernández Pérez1, Andrea Navalón Calzada2, Aarón Gonzalez Espinosa3
1Orthopedics and Traumatology, October 1st Regional High-Specialty Hospital, Institute for Social Security and Services for State Workers (ISSSTE), Mexico City, MEX.
Cureus
|March 19, 2026
Summary
Self-inflicted wrist injuries in flexor tendon zone V are complex, often affecting young men and causing significant functional loss. Standardized care and multidisciplinary approaches are crucial for better outcomes in these challenging cases.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Psychiatry
Background:
- Self-inflicted wrist injuries, especially in flexor tendon zone V, present significant surgical and functional challenges.
- The existing literature lacks standardized definitions (e.g., "spaghetti wrist") and management frameworks for these injuries.
Purpose of the Study:
- To critically synthesize evidence on the epidemiology, classification, assessment, and management of self-inflicted flexor tendon zone V injuries.
- To identify knowledge gaps and areas for consensus in the treatment and rehabilitation of these complex traumas.
Main Methods:
- A narrative review of English and Spanish studies from January 2005 to January 2025.
- Searches included PubMed/MEDLINE, Scopus, and Google Scholar, analyzing cohort studies, case series, case reports, and reviews.
Main Results:
- Injuries predominantly affect young adult males, often involving the dominant hand and extensive structural compromise (tendons, nerves, vessels).
- Neurovascular involvement is a key predictor of long-term prognosis, with psychiatric comorbidity influencing recurrence and adherence to treatment.
- Outcome reporting is heterogeneous due to inconsistencies in definitions, surgical techniques, and rehabilitation protocols.
Conclusions:
- Self-inflicted flexor tendon zone V injuries are complex and heterogeneous, requiring integrated multidisciplinary care.
- While microsurgical repair and rehabilitation have improved outcomes, prognosis is guarded with neurovascular damage.
- Standardized definitions and validated outcome measures are essential for improved patient care and research comparability.
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