Results of primary and secondary flexor-tendon repairs in no man's land

The results of primary and secondary repair of seventy-one flexor-tendon lacerations in Bunnell's no man's land of the hand usually were good when the following principles were adhered to: careful preoperative selection of patients, use of atraumatic technique, avoidance of advancing the flexor digitorum profundus tendon more than one centimeter distally, and caution in performing secondary repairs when both the flexor digitorum superficialis and the profundus were completely severed. Secondary repair resulted in a higher failure rate (loss of extension) only when both tendons were completely severed.