Intisari Sains Medis

Detail Cakupan

Case Presentation: A 37-year-old woman, presented 1 month after a clean volar laceration of the right hand treated only with wound irrigation and skin suturing. She reported persistent loss of grip and fine manipulation in the ring and little fingers. Examination suggested a delayed zone II flexor mechanism injury of digits IV-V (ulnar) without open wound or gross deformity. Operative exploration revealed scarred sheath, adhesions, chronic rupture of both FDP and FDS, and associated pulley deficiency. Because delayed zone II injuries beyond 3 weeks are often considered for staged reconstruction, intraoperative assessment focused on whether the tendon ends remained viable, retrievable, and approximable without undue tension. As these criteria were satisfied, a one-stage primary FDP/FDS repair with concomitant pulley reconstruction was performed. Structured hand therapy followed. At the 1-month follow-up, healing was uneventful, and the DASH score improved from 52.5 preoperatively to 14.2, indicating early improvement in patient-reported disability.