title: Enlargement of the flexor pulleys by an omega plasty: A study comparing the release of one or both sides of the A2 and/or A4 pulley.
abstract: OBJECTIVE
  The omega plasty on one side of the A2 and/or A4 pulley improves the gliding of repaired flexor tendons in zone II. The purpose of this study was whether or not the enlargement of the digital channel was better after the release of one or both sides of each pulley.
  
  
  METHODS
  In fresh cadavers, the technique was to first disinsert the ulnar attachments of the A2 and A4 pulleys and then the radial insertions. An ultrasound was used to measure the large axis, the circumference, and the cross-sectional surface of each of A2 and A4 pulleys before release, after ulnar release and after radial release.
  
  
  RESULTS
  The release of the A2 pulley reduces the risk of conflict in the sutured flexor tendons in the digital channel. The release of the A4 pulley seems less effective than that of A2. The release of the two pulleys reduces the risk of conflict in one sutured zone of the flexor tendons in the digital channel.
  
  
  CONCLUSIONS
  In all, if there is a conflict between the flexor tendons sutured opposite A2, we recommend an omega plasty on the two sides of the pulley. If the conflict appears opposite A4, we recommend the plasty of the two sides of A4 and A2.
authors.affiliation: Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, WFSW, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors.forename: L
authors.initials: L
authors.lastname: Barthel
authors.affiliation: Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, WFSW, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors.forename: C
authors.initials: C
authors.lastname: Taleb
authors.affiliation: Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, WFSW, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors.forename: A
authors.initials: A
authors.lastname: Pereira
authors.affiliation: Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, WFSW, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors.forename: G
authors.initials: G
authors.lastname: Prunières
authors.affiliation: Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, WFSW, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors.forename: S
authors.initials: S
authors.lastname: Hendriks
authors.affiliation: Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, WFSW, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors.forename: S
authors.initials: S
authors.lastname: Facca
authors.affiliation: Department of Plastic Surgery, Strasbourg University Hospitals, FMTS, University of Strasbourg, Strasbourg, France.
authors.forename: F
authors.initials: F
authors.lastname: Bodin
authors.affiliation: Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, WFSW, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France. Electronic address: Philippe.liverneaux@chru-strasbourg.fr.
authors.forename: P
authors.initials: P
authors.lastname: Liverneaux
mesh_terms: D001696:Biomechanical Phenomena; D002102:Cadaver; D005385:Fingers / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D019637:Orthopedic Procedures / Q000379:methods*; D013710:Tendons / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Flexor tendon; Omega; Oméga; Plastie; Plasty; Poulie; Pulley; Tendon fléchisseur