title: Exceptional laceration of flexor digitorum tendons proximal to a severe palmar hand wound: a case report with literature review.
abstract: Hand wounds are common, poor functional outcomes are marked because of sequelae inherent to posttraumatic and postoperative complications. Suitable surgery repair in emergency can ensure best results. Classically, tendon's injuries occur near the injured area and their repair depend on traumatized zone, sutures techniques, associated lesions and surgeon's abilities. We report a case of a farmer who has sustained of a severe hand wound due to blades of a combine harvester. Clinical examination showed exceptional laceration of 2(nd) and 3(rd) flexor digitorum tendons from musculo-tendinous junction, without any lesion in their palmar section. We proceeded; after extensive debridement, abundant lavage and removal of foreign body; to modified Kessler sutures using PDS 4.0 followed by dorsal splint for protecting tendons repair, and progressive rehabilitation program. Final result was interesting after 12 weeks. Thinking to tendon laceration is important, when manipulating machines with rotational movements.
authors.affiliation: Department of Orthopedics, Avicenna University Hospital, Rabat, Morocco.
authors.forename: Badr
authors.initials: B
authors.lastname: Ennaciri
authors.affiliation: Department of Orthopedics, Avicenna University Hospital, Rabat, Morocco.
authors.forename: Mustapha
authors.initials: M
authors.lastname: Mahfoud
authors.affiliation: Department of Orthopedics, Avicenna University Hospital, Rabat, Morocco.
authors.forename: Ahmed
authors.initials: A
authors.lastname: El Bardouni
authors.affiliation: Department of Orthopedics, Avicenna University Hospital, Rabat, Morocco.
authors.forename: Mohamed Saleh
authors.initials: MS
authors.lastname: Berrada
mesh_terms: D000062:Accidents, Occupational; D000328:Adult; D003646:Debridement / Q000379:methods; D000067565:Farmers; D005547:Foreign Bodies / Q000601:surgery; D006230:Hand Injuries / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D022125:Lacerations / Q000473:pathology / Q000601:surgery*; D008297:Male; D013536:Suture Techniques; D013708:Tendon Injuries / Q000473:pathology / Q000601:surgery*
keywords: Flexor tendons; Kessler suture; hand wound