DIGITAL PULLEY system guides flexor tendon excursion into efficient and useful motion at the interphalangeal (IP) joints. Damage or resection of the pulleys results in volar displacement of the flexor tendons and decreases their effectiveness on IP joint motion.

2024年11月22日 · unclear if A4 reconstruction is absolutely necessary (can be sacrificed during acute flexor tendon surgery)

- the A2 and A4 pulleys are essential to prevent flexor tendon bow stringing; - inadequate pulley reconstruction will lead to bowstringing of the flexor tendon; - include use of a portion of FDS, free tendon graft, or extensor retinaculum; - reconstruction is performed to a remnant of the destroyed pulley, thru bone holes, or encircling the ...

2010年2月3日 · Two main techniques are available for pulley reconstruction: weaving the pulley graft through the remaining pulley rim, or making an entirely new pulley loop around bone .

2018年10月5日 · To reconstruct the A2 and A4 pulleys, we used the single-loop technique using FDP tendon as a free tendon graft.

2013年4月8日 · For A2 reconstructions, passing the graft directly along the proximal phalanx raises the theoretical concern of vascular compromise to the flexor tendons 35 and potential bone resorption underneath the pulley graft. 59 The addition of more loops to the pulley reconstruction helps to match the native pulley length and strength. 6 Surgeons must ...

2024年1月27日 · Surgical intervention is indicated in patients with spontaneous A2 pulley insufficiency with local tenderness caused by tendon bowstringing (after the failure of conservative therapy). Climbing activity is associated with pulley injury for many patients.

Case Report: We describe a closed traumatic annular 2 (A2) through annular 4 (A4) pulley rupture with avulsion of the FDS tendon. This uniquely associated pathology was treated with a complex surgical reconstruction that corrected flexion contracture and …

2020年9月1日 · Loss of pulley function can lead to significant impairment of hand function and may require surgical reconstruction. This reconstruction can be achieved using different flexor tendons grafts, such as the intrasynovial flexor digitorum superficialis (FDS) or the extrasynovial palmaris longus (PL).

A2 and A4 are the most important flexor pulleys to avoid flexor tendon bowstringing and are there- fore the most commonly reconstructed. However, recent studies indicate that both A2 and A4 may not need to be fully intact to avoid bow-