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PUBMED FOR HANDHELDS

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  • Title: Flexor pulley system: anatomy, injury, and management.
    Author: Zafonte B, Rendulic D, Szabo RM.
    Journal: J Hand Surg Am; 2014 Dec; 39(12):2525-32; quiz 2533. PubMed ID: 25459958.
    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 once-held dogma that preserving the integrity of the entire A2 and A4 pulleys is indispensable for normal digit function.
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