title: Intermittent unspecific osteitis and cortex atrophy of the proximal phalanx after surgical pulley repair.
abstract: Climbing athletes frequently suffer from pulley ruptures, as the shear stress on the finger flexor tendon pulley system is extremely high, especially in the 'crimping position'. Studies showed that surgery only has to be performed in a multiple pulley rupture situation (grade IV injuries). This case describes a complication that appeared after performing a 'bone-encircling' technique recommended for climbers (modified 'one-and-a-half-loop' technique). Simultaneously with resumption of full-strength training after surgery and rehabilitation, the dorsolateral cortex of the proximal phalanx, to which the tendon transplant (palmaris longus tendon surrounding bone and flexor tendon of the finger) is entangled, developed an osteitis and atrophy. We investigated two athletes with the same complaints and symptoms.
authors.affiliation: CvPath Institute, Gaithersburg, Maryland, USA Department of Sports Orthopedics, Sports Medicine, Sports Traumatology, Department for Orthopedics and Traumatology, Klinikum Bamberg, Bamberg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Lutter
authors.affiliation: Department of Sports Orthopedics, Sports Medicine, Sports Traumatology, Department for Orthopedics and Traumatology, Klinikum Bamberg, Bamberg, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Schoeffl
mesh_terms: D000328:Adult; D001284:Atrophy; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000473:pathology*; D050278:Finger Phalanges / Q000000981:diagnostic imaging / Q000473:pathology; D005385:Fingers / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009051:Mountaineering; D010000:Osteitis / Q000000981:diagnostic imaging / Q000473:pathology*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography; D013314:Stress, Mechanical; D013708:Tendon Injuries / Q000601:surgery*; D013710:Tendons / Q000637:transplantation*; D014463:Ultrasonography