Reconstruction of the digital flexor pulley system: a retrospective comparison of two methods of treatment

J Hand Surg Eur Vol. 2007 Feb;32(1):60-6. doi: 10.1016/j.jhsb.2006.09.019. Epub 2006 Nov 28.

Abstract

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.

MeSH terms

  • Adult
  • Connective Tissue / transplantation*
  • Female
  • Finger Injuries / surgery*
  • Hand Strength / physiology
  • Humans
  • Male
  • Middle Aged
  • Motor Skills / physiology
  • Postoperative Complications / physiopathology
  • Range of Motion, Articular / physiology
  • Retrospective Studies
  • Rupture
  • Suture Techniques
  • Tendon Injuries / surgery*
  • Tendon Transfer / methods*
  • Wound Healing / physiology