Hand injuries: flexor tendon zone II: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Hand injuries: flexor tendon zone II

Sample item

A laceration across the proximal phalanx of the index finger divides both flexor tendons within the digital sheath. Why is repair in this zone traditionally called a no man's land problem?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Both flexor tendons lie tightly in the fibro-osseous sheath, so adhesions often limit gliding after repair

Zone II extends from the A1 pulley to the insertion of flexor digitorum superficialis. Both FDS and FDP run together in a tight sheath, so repair often forms adhesions that block gliding. Early controlled mobilisation after careful repair is used to limit this problem.

Option by option

  • A. The digital arteries are absent and necrosis is certain

    The digital vessels are present, and necrosis is not inevitable.

  • B. Only the profundus tendon is present, so repair is not possible

    FDS and FDP both exist here, and both can be repaired.

  • C. Both flexor tendons lie tightly in the fibro-osseous sheath, so adhesions often limit gliding after repair (correct)

    Correct. The crowded sheath with both tendons makes post-repair adhesions common.

  • D. The flexor tendons are absent in this zone

    Both flexor tendons are present in the digital sheath in zone II.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Both flexor tendons lie tightly in the fibro-osseous sheath, so adhesions often limit gliding after repair. Zone II extends from the A1 pulley to the insertion of flexor digitorum superficialis.

Why is "The digital arteries are absent and necrosis is certain" not the answer?

The digital vessels are present, and necrosis is not inevitable.

Why is "Only the profundus tendon is present, so repair is not possible" not the answer?

FDS and FDP both exist here, and both can be repaired.

Why is "The flexor tendons are absent in this zone" not the answer?

Both flexor tendons are present in the digital sheath in zone II.

What concept does this question test?

It tests Hand injuries: flexor tendon zone II in Orthopaedics. Both FDS and FDP run together in a tight sheath, so repair often forms adhesions that block gliding. Early controlled mobilisation after careful repair is used to limit this problem.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hand injuries: flexor tendon zone II?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.