Jerliu Aulon, Downton Ramos Herbert, Jabbour Jacob I
Surgery, University of Connecticut School of Medicine, Farmington, USA.
General Surgery, University of Connecticut School of Medicine, Farmington, USA.
Cureus. 2025 Aug 23;17(8):e90803. doi: 10.7759/cureus.90803. eCollection 2025 Aug.
We present a case of a 67-year-old male who sustained a complex glass injury to the right palm involving Zone 3. Intraoperative exploration revealed full-thickness lacerations of the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) tendons to all four fingers, a 22 mm median nerve gap requiring cabled nerve allograft repair, laceration of the deep motor branch of the ulnar nerve and fourth common digital nerve requiring conduit-assisted repairs, and a segmental laceration of the ulnar artery requiring microsurgical reconstruction. The patient underwent staged reconstruction over two operations, including tendon repairs, nerve grafting with cabled decellularized frozen nerve allograft, vascular repair, and soft tissue coverage with adjacent tissue transfer. This case highlights the complexity of Zone 3 hand injuries and underscores the importance of staged surgical decision-making, nerve reconstruction strategies, and prioritization of neurovascular and tendon repair in high-impact penetrating glass trauma. The patient provided written informed consent for publication of all clinical details and images.
我们报告一例67岁男性患者，其右手掌3区遭受复杂玻璃损伤。术中探查发现，所有4根手指的指深屈肌腱（FDP）和指浅屈肌腱（FDS）均有全层撕裂伤，正中神经有22毫米的缺损，需要进行带缆线神经同种异体移植修复；尺神经深运动支和第四指总神经有撕裂伤，需要进行导管辅助修复；尺动脉有节段性撕裂伤，需要进行显微外科重建。该患者分两次手术进行分期重建，包括肌腱修复、使用带缆线脱细胞冷冻神经同种异体移植进行神经移植、血管修复以及采用邻位组织转移进行软组织覆盖。本病例突出了手部3区损伤的复杂性，并强调了在严重穿透性玻璃创伤中进行分期手术决策、神经重建策略以及优先进行神经血管和肌腱修复的重要性。患者已书面同意发表所有临床细节和图像。
