Fathi Afshin
Department of Plastic and Reconstructive Surgery, Tehran University of Medical Sciences, Tehran, Iran.
World J Plast Surg. 2020 Sep;9(3):321-325. doi: 10.29252/wjps.9.3.321.
Hand Zone 2 flexor injuries are among the most important tendon lesions and its prognosis is poorer than the other hand zones. Limited incisions prevent multiple skin flaps. The present study aimed to determine the location of palmar flexor tendons using surface anatomical markers to provide a simple and easy guide for hand surgeons assisting them in minimal incisions.
Patients with hand injuries in Zone 2 were taken to the operating room for surgery. The skin and subcutaneous tissue over the flexor tendons sheath were incised. After finding the flexor tendons in the palm, their exact position was located with a blue needle (23G) over the palm crease and marked relative to the finger borders.
Thirty-eight patients with the mean age of 27±3.6 years were operated. Totally, 57 fingers and 38 palms were dissected. The flexor tendons were located under the proximal and distal palm creases between two parallel lines extended from finger borders and mid-axial axis of the fingers. The average distance from finger print to distal palmar crease was 25, 32 and 24 mm for little, ring and long finger, respectively and 32 mm from index finger print to mid palmar crease.
The precise position of flexor tendons can be easily determined in the palm according to surface anatomical markers and plan for limited incisions.
手部2区屈指肌腱损伤是最重要的肌腱损伤之一，其预后比手部其他区域更差。有限的切口可避免多个皮瓣。本研究旨在利用表面解剖标志确定掌侧屈指肌腱的位置，为手外科医生提供简单易行的指导，以协助他们进行最小切口手术。
将手部2区损伤的患者送入手术室进行手术。切开屈指肌腱腱鞘上方的皮肤和皮下组织。在手掌中找到屈指肌腱后，用蓝色针头（23G）在掌横纹上方确定其确切位置，并相对于手指边界进行标记。
对38例平均年龄为27±3.6岁的患者进行了手术。共解剖了57根手指和38只手掌。屈指肌腱位于从手指边界和手指中轴线延伸的两条平行线之间的近端和远端掌横纹下方。小指、环指和中指从指纹到远端掌横纹的平均距离分别为25、32和24毫米，食指指纹到掌横纹中点的距离为32毫米。
根据表面解剖标志可轻松确定手掌中屈指肌腱的精确位置，并制定有限切口方案。
