In flexor tendon injuries of the hand, Zone II (the 'critical zone' or 'no man's land') extends from:

• A The wrist crease to the metacarpophalangeal joint
• B The distal palmar crease to the middle of the middle phalanx
• C From the A1 pulley (proximal edge of the fibro-osseous tunnel at the MCP joint) to the insertion of FDS at the middle phalanx ✓
• D The DIP joint to the fingertip

Explanation

Zone II in flexor tendon anatomy extends from the A1 pulley (entrance to the flexor tendon sheath at the MCP level) to the insertion of the flexor digitorum superficialis on the middle phalanx. It is called the critical or 'no man's land' because both FDP and FDS run through the tight fibro-osseous tunnel here; repair is technically demanding, adhesion formation is maximal, and historically results were poor. Modern primary repair with Kessler/modified Kessler core sutures followed by early active mobilisation has transformed outcomes. Zone I is distal to FDS insertion; Zone III is in the palm; Zone IV is the carpal tunnel; Zone V is the forearm.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.