1. extensor
   1. extebsir zibes: Zone 1 (distal interphalangeal [DIP] joint) Zone 2 (middle phalanx) Zone 3 (proximal interphalangeal [PIP] joint) Zone 4 (proximal phalanx) Zone 5 (metacarpophalangeal [MCP] joint) Zone 6 (dorsum of hand) Zone 7 (wrist) Zone 8 (dorsal forearm)
      1. Topic
         1. 6 compartments at the dorsal wrist
            1. Extensor digitorum
            2. Subtopic 2
            3. Subtopic 1
            4. extensor expansion (dorsal expansion, dorsal hood): extensor tendon will expand to form a hood, which covers the back and sides of the head of the metacarpal and the proximal phalanx then devides to 3 bands
            5. I. lateral bands pass on either side of the proximal phalanx and stretch all the way to the distal phalanx
            6. Attach to the 1.lumbricals 2.extensor indicis muscle,3. dorsal & palmar interossei
            7. Subtopic 1
            8. Subtopic 2
            9. II. central slip attach to the dorsal of the middle phalanx
            10. III. retinacular ligament runs obliquely along the middle phalanx, and connects the fibrous digital sheath on the anterior side of the phalanges to the extensor expansion.
            11. Subtopic 4
         2. Subtopic 2
2. Kirchmayr tendon laceration repair suture
   1. Kirchmayr tendon laceration repair suture technique.
   2. Subtopic 2
   3. Subtopic 3
3. Main Topic 3
4. Flexor
   1. Zone I consists of the profundus tendon only and is bounded proximally by the insertion of the superficialis tendons and distally by the insertion of the flexor digitorum profundus (FDP) tendon into the distal phalanx. Zone II is often referred to as "Bunnell's no man's land," indicating the frequent occurrence of restrictive adhesion bands around lacerations in this area. Proximal to zone II, the flexor digitorum superficialis (FDS) tendons lie superficial to the FDP tendons. Within zone II and at the level of the proximal third of the proximal phalanx, the FDS tendons split into 2 slips, collectively known as Camper chiasma. These slips then divide around the FDP tendon and reunite on the dorsal aspect of the FDP, inserting into the distal end of the middle phalanx. Zone III extends from the distal edge of the carpal ligament to the proximal edge of the A1 pulley, which is the entrance of the tendon sheath (see the A1 pulley in the image above). Within zone III, the lumbrical muscles originate from the FDP tendons. Zone IV includes the carpal tunnel and its contents (ie, the 9 digital flexors and the median nerve). | Zone V extends from the origin of the flexor tendons at their respective muscle bellies to the proximal edge of the carpal tunnel.
      1. zones
         1. Zone 1 is distal to the insertion of the FDS tendon. A laceration in zone 1, by definition, injures only the tendon of the FDP
            1. Subtopic 1
         2. zone 2, or “no man's land.: start from proximal aspect of the A1 pulley to FDS insertion,The distal palmar crease superficially marks the termination of zone 3 and the beginning of zone 2.
            1. finger pulleys
            2. Topic
            3. P2 at base of P1 must be preserved in trigger release
            4. thumb pulleys
            5. A1 pulley - The first annular pulley is located at the level of the MCP joint;= like all the A1 pulley for all other fingers
            6. A1 and PA pulleys are the only ones cut in trigger release surgery
            7. Oblique pulley -at midportion of the proximal phalanx; t
            8. A2 pulley is from the volar plate of the interphalangeal joint
         3. Zone 3 from the distal edge of the carpal ligament to the proximal edge of the A1 pulley.
            1. PA (Palmar aponeurosis) pulley: about 1cm proximal to the A1 pulley
            2. which is the entrance of the tendon sheath (see the A1 pulley in the image above). Within zone III, the lumbrical muscles originate from the FDP tendons.
         4. zone 4 is the carpal tunnel and its contents.
            1. flexor retinaculum (transverse carpal ligament, or anterior annular ligament) is the roof of the carpal tunnel, & is released in carpal tunnel syndrome
            2. ulnar canal or ulnar tunnel, also called Guyon's canal, is a space at the wrist between the pisiform bone and the hamate bone through which the ulnar artery and the ulnar nerve travel into the hand.
         5. Zone 5 extends from the muscle-tendon junction to the proximal aspect of the carpal tunnel,
      2. zone 5 =flexor Mu. insertion to carpal tunnel