flexor tendon

Question 1

volar superficial tendons

Answer 1

cruciate
transverse metacarpal
annular pulleys
synovial sheath

Question 2

Flexor zone 1

Answer 2

Only FDP tendon located
If injured only FDP is lasered
Flexion loss occurs in DIP joint

Question 3

Flexor zone 2

Answer 3

Fibroosseous sheath located from metacarpal head to FDS insertion
Neutral zone [no man’s hand] bcz it’s a problematic area to heal after repair

Question 4

Flexor zone 3

Answer 4

from distal carpal tunnel to metacarpal head

Question 5

Flexor zone 4

Answer 5

Carpal tunnel area
9 flexor tendons
Median nerve

Question 6

Flexor zone 5

Answer 6

Distal 1/3 of forearm to proximal of the flexor retinaculum

Question 7

goals of rehab

Answer 7

Prevent tendon rupture
Prevent contractures
Stimulates tendon healing
ROM
Reach functional level before injury

Question 8

Early rehab [1-4 weeks]

Answer 8

Immobilization = IP neutral, wrist 30-40 flex, mcp 40-60 flex and dorsal blockage splint
Early passive mobilization [Duran houser procedure]
Early active mobilization [Kleinert procedure]

Question 9

Duran houser procedure

Answer 9

Controlled passive movements
Wrist 20 flex
mcp 50 flex
IP neutral
Dorsal blockage splint
PIP 30 flex if nerve repair

Question 10

Kleinert procedure

Answer 10

Controlled active movements
Wrist 30-40 flex
mcp 60-70 flex
IP full extension
Dorsal blockage splint + rubber or spring

Question 11

Early-mid rehab [4-6 weeks]

Answer 11

Active wrist extension
Passive flex-ext all fingers
No wrist extension + finger extension

Question 12

Mid rehab [6-8 weeks]

Answer 12

Active stretching
Electrical stimulation
Tendon gliding and blocking exercises

Question 13

late rehab period [8-12 weeks]

Answer 13

Strengthening
stretching splint on volar side