The contraindications to primary repair of a flexor tendon injury are:

A. Contaminated wound.

B. Severe soft tissue trauma.

C. Inexperienced surgeon.

D. Compromised general condition of the patient prohibiting prolonged anesthetic. 

DISCUSSION: The prerequisites for primary repair (within 24 hours of injury) of a flexor tendon injury are (1) a clean wound or one that may be débrided to a clean status, (2) minimal soft tissue injury providing a relatively stable soft tissue environment, (3) a surgeon experienced in flexor tendon repair, (4) adequate anesthetic condition of the patient, and (5) appropriate supportive staff (operating room personnel). If all of these conditions are met, primary repair may be performed allowing accurate anatomic alignment and quicker rehabilitation. Delayed repair is indicated if one or more of these prerequisites are not met.