Background

Flexor tendon injuries of the hand are commonly seen in orthopedic surgery practice. Typically, these injuries are the result of a laceration, crush, or injury sustained during contact sports and may have a considerable effect on a patient's quality of life. The physical examination is critical for diagnosis, and each of the flexor tendons of the digits (flexor digitorum superficialis and flexor digitorum profundus ) are tested independently. The Verdan classification is the most commonly referenced system to classify flexor tendon injuries. Zone I injuries, which occur distal to the insertion of the flexor digitorum superficialis are notoriously difficult to manage; however, outcomes have improved secondary to novel repair methods. The cross-locked cruciate technique can be used to manage zone I flexor tendon injuries.

Purpose

This video provides an overview of and discusses a case presentation on repair of a zone I flexor tendon injury via the cross-locked cruciate technique.

Methods

The anatomy, classification, diagnosis, and management of flexor tendon injuries are reviewed. The video discusses surgical indications and considerations, including approach and repair. The case presentation of a 21-year-old right hand-dominant man who sustained a volar zone I laceration of the right little finger while opening a pizza box 2 weeks prior to presentation is reviewed.

Results

Cross-locked cruciate repair is an effective technique to treat and restore function in patients with a zone I flexor tendon injury.

Conclusion

Flexor tendon injuries are commonly seen in orthopaedic practices and may have devastating effects on patient quality of life. Zone I injuries are notoriously difficult to manage, resulting in impaired function postoperatively. The cross-locked cruciate technique is an effective method for restoring function and treating patients with a zone I flexor tendon injury.