Flexor Tendon Lacerations Clinical Presentation

Updated: Aug 17, 2016
  • Author: Benjamin C Wood, MD; Chief Editor: Jorge I de la Torre, MD, FACS  more...
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Presentation

History and Physical Examination

Clinical examination is an essential part of the assessment of any patient who presents with a hand injury. Clinical clues to flexor tendon injury include loss of the normal digital cascade and the tenodesis effect observed with wrist motion. In lacerations of the flexor digitorum profundus (FDP) alone, the distal interphalangeal (DIP) joint may be held in flexion by the intact short vinculum. Isolated flexor digitorum superficialis (FDS) injury results in no overt postural deficit.

Identification of damaged structures is best performed by a hand surgeon; several reports have noted underdiagnosis of hand injuries when the injuries were examined by emergency department (ED) staff alone. [8]  Moreover, diagnoses were missed despite examination by a hand surgeon, making the involvement of a surgeon critical, in that those injuries can be identified and repaired on formal exploration. [9]