Outcome of Combined or Single Flexor Digitorum Superficialis and Flexor Digitorum Profundus Repair in Zone II

Abstract

Objectives: To evaluate the outcomes of the repair of flexor digitorum Profundus (FDP) alone versus its repair combined with flexor digitorum superficialis (FDS) repair in Zone II flexor tendon injury. Background: Flexor tendon injuries in zone II of the hand present a challenging problem for hand surgeons. Injuries involving the FDP and FDS tendons require careful assessment and planning. The primary goals of repair are to achieve optimal tendon healing, maximize range of motion, and restore functional strength. Methods: A total of 24 patients presenting with FDP and FDP injury at zone II were surgically treated from 2020 to 2022. The patients were divided into two groups where Grpup A (repair of FDP only), and Group B (both FDP and FDS were repaired). The functional outcomes were assessed using the Tang grading system, total passive range of motion, and Grip strength. Results: Twelve patients (21 fingers) had FDP only repair, while in Group B (19 fingers) had both FDP and FDS repaired. There were no any significant differences between the two groups regarding range of movement and grip strength, but there was a significant difference regarding the quickDASH score. The patients with FDP only showed significantly less flexion deformity at the operated digits PIP joint (p< 0.008). Conclusions: In conclusion, the decision regarding FDP repair alone or combined FDS and FDP repair in zone II is highly individualized and based on a comprehensive evaluation of the specific injury, the condition of the tendons, and the patient's functional goals.