Flexor Tendon Injuries

Abstract

Each of the fingers has a flexor digitorum sublimis tendon and a flexor digitorum profundus tendon. The flexor digitorum profundus tendons have a common muscle belly and are interconnected at the musculotendinous junction, thereby restricting independent profundus excursion, resulting in combined motion of all four profundus tendons with the so-called quadrigia effect. The blood supply to the flexor tendons is obtained from the dorsal side of the tendons through the vinculae. Core sutures used in the repair of lacerated tendons should be placed in the palmar half of the tendon to help preserve the dorsal blood supply. Although at one time it was recommended not to repair both tendons and, in fact, occasionally to excise the stump of the sublimis, it is now generally accepted that the appropriate treatment should be repair of both tendons. This has the advantage of maintaining the vincula system and, therefore, the blood supply to the tendons (Fig. 3–1).