A 35-year-old carpenter presents with a volar laceration at the wrist involving the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) tendons in zone II. Regarding primary tendon repair in this zone, which statement is correct?

• A Primary repair is contraindicated; staged reconstruction with silicone rod is mandatory
• B Only FDS should be repaired; FDP repair in zone II leads to a high rate of adhesions
• C Primary repair should be avoided within 24 hours; delayed primary repair at 7–10 days gives best outcomes
• D Both FDP and FDS should undergo primary repair with a core suture and epitendinous suture, followed by early controlled motion ✓

Explanation

Current evidence strongly supports primary repair of both FDP and FDS tendons in zone II (the critical zone within the flexor sheath) within 12–24 hours of injury, using a multi-strand core suture technique (4- or 6-strand) plus a running epitendinous suture, which significantly increases repair strength and reduces gap formation. Early controlled passive motion (Kleinert or Duran protocol) reduces adhesion formation and improves excursion. Staged reconstruction is reserved for contaminated wounds or delayed presentations with fibrosis.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.