Exceptional laceration of flexor digitorum tendons proximal to a severe palmar hand wound: a case report with literature review

Abstract

Hand wounds are common, poor functional outcomes are marked because of sequelae inherent to   posttraumatic and postoperative complications. Suitable surgery repair in emergency can ensure best results. Classically, tendon's injuries occur near the injured area and their repair depend on traumatized zone, sutures techniques, associated lesions and surgeon's abilities. We report a case of a farmer who has sustained of a  severe hand wound due to blades of a combine harvester. Clinical examination showed exceptional laceration  of 2nd and 3rd flexor digitorum tendons from musculo-tendinous junction, without any lesion in their palmar  section. We proceeded; after extensive debridement, abundant lavage and removal of foreign body; to modified Kessler sutures using PDS 4.0 followed by dorsal splint for protecting tendons repair, and progressive  rehabilitation program. Final result was interesting after 12 weeks. Thinking to tendon laceration is important, when manipulating machines with rotational movements.

Key words: Flexor tendons, Kessler suture, hand wound