Flexor digitorum profundus injuries

Pathological classification

Type 1 tendon retracts to palm, blood supply disrupted, tendon sheath scar
Type 2tendon retracts to proximal interphalangeal joint, flexor digitorum profundus is caught at chiasm of flexor digitorum superficialis
Type 3flexor digitorum profundus avulsion plus large osseous fragment. Bony fragment lodged at distal edge of A4 pulley

Zonal classification

Zone 1 from fingertip to midportion of middle phalanx
Zone 2from midportion of middle phalanx to distal palmar crease
Zone 3from distal palmar crease to distal edge of carpal tunnel
Zone 4in carpal tunnel
Zone 5proximal to carpal tunnel

Flexor digitorum profundus disruption classification

Type Iflexor digitorum profundus retracts to palm
Type IIvincula vessels intact; a tether retracts flexor digitorum profundus
Type IIIa large bony fragment catches on A4 or A5 pulley
Type IVfractures at flexor digitorum profundus insertion, retraction permitted by separation of tendon from bone