title: Reconstruction of the digital flexor pulley system: a retrospective comparison of two methods of treatment.
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.
authors.affiliation: Department of Trauma Surgery and Sports Medicine, Medical University Innsbruck (MUI), Innsbruck, Austria. rohit.arora@uibk.ac.at
authors.forename: R
authors.initials: R
authors.lastname: Arora
authors.forename: D
authors.initials: D
authors.lastname: Fritz
authors.forename: R
authors.initials: R
authors.lastname: Zimmermann
authors.forename: M
authors.initials: M
authors.lastname: Lutz
authors.forename: F
authors.initials: F
authors.lastname: Kamelger
authors.forename: A S
authors.initials: AS
authors.lastname: Klauser
authors.forename: M
authors.initials: M
authors.lastname: Gabl
mesh_terms: D000328:Adult; D003238:Connective Tissue / Q000637:transplantation*; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology; D011183:Postoperative Complications / Q000503:physiopathology; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D012421:Rupture; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*; D013709:Tendon Transfer / Q000379:methods*; D014945:Wound Healing / Q000502:physiology