Flexor pulley system: Anatomy, injury, and management

Brian Zafonte, Dora Rendulic, Robert M Szabo

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Flexor pulley injuries are most commonly seen in avid rock climbers; however, reports of pulley ruptures in nonclimbers are increasing. In addition to traumatic disruption, corticosteroid-induced pulley rupture has been reported as a complication of treating stenosing tenosynovitis. Over the last decade, there have been 2 new developments in the way hand surgeons think about the flexor pulley system. First, the thumb pulley system has been shown to have 4 component constituents, in contrast to the classic teaching of 3 pulleys. Second, in cases of zone II flexor tendon injury, the intentional partial A2 and/or A4 pulley excision or venting is emerging as a component for successful treatment. This is challenging the onceheld dogma that preserving the integrity of the entire A2 and A4 pulleys is indispensable for normal digit function.

Original languageEnglish (US)
Pages (from-to)2525-2532
Number of pages8
JournalJournal of Hand Surgery
Volume39
Issue number12
DOIs
StatePublished - 2014

Fingerprint

varespladib methyl
Rupture
Anatomy
Tendon Entrapment
Tendon Injuries
Thumb
Wounds and Injuries
Adrenal Cortex Hormones
Teaching
Hand
Therapeutics
Surgeons

Keywords

  • Annular pulley
  • Flexor pulley
  • Pulley reconstruction
  • Pulley rupture
  • Rock climbing

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Flexor pulley system : Anatomy, injury, and management. / Zafonte, Brian; Rendulic, Dora; Szabo, Robert M.

In: Journal of Hand Surgery, Vol. 39, No. 12, 2014, p. 2525-2532.

Research output: Contribution to journalArticle

Zafonte, Brian ; Rendulic, Dora ; Szabo, Robert M. / Flexor pulley system : Anatomy, injury, and management. In: Journal of Hand Surgery. 2014 ; Vol. 39, No. 12. pp. 2525-2532.
@article{0a2e202d0c1444a79133e1ab76dedb9d,
title = "Flexor pulley system: Anatomy, injury, and management",
abstract = "Flexor pulley injuries are most commonly seen in avid rock climbers; however, reports of pulley ruptures in nonclimbers are increasing. In addition to traumatic disruption, corticosteroid-induced pulley rupture has been reported as a complication of treating stenosing tenosynovitis. Over the last decade, there have been 2 new developments in the way hand surgeons think about the flexor pulley system. First, the thumb pulley system has been shown to have 4 component constituents, in contrast to the classic teaching of 3 pulleys. Second, in cases of zone II flexor tendon injury, the intentional partial A2 and/or A4 pulley excision or venting is emerging as a component for successful treatment. This is challenging the onceheld dogma that preserving the integrity of the entire A2 and A4 pulleys is indispensable for normal digit function.",
keywords = "Annular pulley, Flexor pulley, Pulley reconstruction, Pulley rupture, Rock climbing",
author = "Brian Zafonte and Dora Rendulic and Szabo, {Robert M}",
year = "2014",
doi = "10.1016/j.jhsa.2014.06.005",
language = "English (US)",
volume = "39",
pages = "2525--2532",
journal = "The Hand",
issn = "1753-1934",
publisher = "SAGE Publications Ltd",
number = "12",

}

TY - JOUR

T1 - Flexor pulley system

T2 - Anatomy, injury, and management

AU - Zafonte, Brian

AU - Rendulic, Dora

AU - Szabo, Robert M

PY - 2014

Y1 - 2014

N2 - Flexor pulley injuries are most commonly seen in avid rock climbers; however, reports of pulley ruptures in nonclimbers are increasing. In addition to traumatic disruption, corticosteroid-induced pulley rupture has been reported as a complication of treating stenosing tenosynovitis. Over the last decade, there have been 2 new developments in the way hand surgeons think about the flexor pulley system. First, the thumb pulley system has been shown to have 4 component constituents, in contrast to the classic teaching of 3 pulleys. Second, in cases of zone II flexor tendon injury, the intentional partial A2 and/or A4 pulley excision or venting is emerging as a component for successful treatment. This is challenging the onceheld dogma that preserving the integrity of the entire A2 and A4 pulleys is indispensable for normal digit function.

AB - Flexor pulley injuries are most commonly seen in avid rock climbers; however, reports of pulley ruptures in nonclimbers are increasing. In addition to traumatic disruption, corticosteroid-induced pulley rupture has been reported as a complication of treating stenosing tenosynovitis. Over the last decade, there have been 2 new developments in the way hand surgeons think about the flexor pulley system. First, the thumb pulley system has been shown to have 4 component constituents, in contrast to the classic teaching of 3 pulleys. Second, in cases of zone II flexor tendon injury, the intentional partial A2 and/or A4 pulley excision or venting is emerging as a component for successful treatment. This is challenging the onceheld dogma that preserving the integrity of the entire A2 and A4 pulleys is indispensable for normal digit function.

KW - Annular pulley

KW - Flexor pulley

KW - Pulley reconstruction

KW - Pulley rupture

KW - Rock climbing

UR - http://www.scopus.com/inward/record.url?scp=84927613143&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84927613143&partnerID=8YFLogxK

U2 - 10.1016/j.jhsa.2014.06.005

DO - 10.1016/j.jhsa.2014.06.005

M3 - Article

C2 - 25459958

AN - SCOPUS:84927613143

VL - 39

SP - 2525

EP - 2532

JO - The Hand

JF - The Hand

SN - 1753-1934

IS - 12

ER -