Ortho Oracle - orthopaedic operative atlas
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Zone III


- Discussion:
    - extends from base of palm or distal end of transverse retinacular ligament to transverse crease in the palm;
          - extends just proximal to the IP joint and to the MP joint;
    - in this region tendons are essentially free of a tendon sheath
    - lacerations in zone III may affect lumbricals inaddition to flexor tendons;
           - damaged lumbrical is either repaired or excised depending on severity or injury and the location of the laceration;
    - if lumbricals are intact, it is left adjacent to FDP repair;
         - it is not wrapped around the repaired flexor;
         - lumbrical contracture is avoided if this muscle is not tightened or manipulated excessively during the repair;
    - if both tendons are lacerated, both are repaired, end to end with circumferential reenforcing sutures;
         - excision of the superficialis tendon is not advised