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Reconstruction of The Digital Flexor Pulley System: A Retrospective Comparison of Two Methods of Treatment

From the Department of Trauma Surgery, and Sports Medicine, and Department of Radiology, Medical University Innsbruck (MUI), Innsbruck, Austria

Correspondence: Rohit Arora, Department of Trauma Surgery and Sports Medicine, Medical University Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria. Tel.: +43 512 504 22821; Fax +43 512 504 22824 E-mail:rohit.arora{at}uibk.ac.at

The rare injury of closed rupture of the A2 and A3 flexor pulleys was treated using two non-encircling techniques of pulley reconstruction. Thirteen patients were treated with an extensor retinaculum graft (Group A). At a mean follow-up time of 48 months, the average PIP flexion was 97%, the power grip strength 96%, the pinch grip strength 100% and the thickening 94% of the uninjured side. Ten patients were treated with a free palmaris longus tendon grafts (Group B). At a mean follow-up time of 57 months, the average PIP flexion was 94%, the power grip strength 98%, the pinch grip strength 100% and the thickening 95% of the uninjured side. In both groups, finger extension was unrestricted. The Buck Gramcko score included 10 excellent, two good and one fair result in Group A and seven excellent, two good and one fair result in Group B. Both techniques proved beneficial. All climbers returned to their previous standard and all non-climbers regained full finger dexterity in their previous job.

Key Words: finger pulley rupture • extensor retinaculum graft • finger pulley reconstruction • bowstringing

Journal of Hand Surgery (European Volume), Vol. 32, No. 1, 60-66 (2007)
DOI: 10.1016/j.jhsb.2006.09.019


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