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Evidence. Clarity. Practice.

© 2026 OrthoVellum. For educational purposes only.

Not medical advice. Verify clinically important information against current local guidance.

Back to Research
Level IIIMust KnowHand & Upper LimbRetrospective Cohort

Evidence brief

Zone II Flexor Tendon Repair

Flexor Tendon Repair: Zone II 'No Man's Land'

Authors
Strickland JW, Glogovac SV
Journal
J Hand Surg Am
Year
1980

Key Findings

  • 1

    Zone II (A1 to FDS insertion) historically 'no man's land'

  • 2

    Modern repair techniques achieve 75-90% good/excellent results

  • 3

    Core suture strength critical (4-6 strand)

  • 4

    Early controlled motion improves outcomes

  • 5

    Adhesion formation remains challenge

Clinical Implications

Zone II flexor tendon repair has evolved from a procedure to avoid to one with good outcomes using modern techniques. Strong repair allowing early motion is key to success.

Teaching Note

Know the 5 flexor zones. Zone II most challenging due to tendon sheath constraints. Repair principles: strong core suture (4-6 strand), epitendinous suture, preserve pulleys (A2, A4 critical), early motion protocol. Discuss Duran/Kleinert protocols.

Citation

Strickland JW, Glogovac SV. Digital function following flexor tendon repair in zone II: a comparison of immobilization and controlled passive motion techniques. J Hand Surg Am. 1980;5(6):537-543.

PubMed

Evidence Level

III

Level III

Retrospective comparative study or case-control study

Topics

flexor tendonzone IIrepairrehabilitation

Related Topics

  • Flexor Tendon Lacerations
  • Tendon Repair
  • Hand Therapy

External Links

View on PubMed

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