title: Pulley Ruptures in Rock Climbers: Outcome of Conservative Treatment With the Pulley-Protection Splint-A Series of 47 Cases.
abstract: OBJECTIVE
  To evaluate the effectiveness of conservative treatment of finger flexor tendon pulley rupture with a pulley-protection splint (PPS) with regard to reduction in tendon-phalanx distance (TPD) and functional and sport-specific outcomes in a retrospective case series.
  
  
  METHODS
  Tendon-phalanx distance in active forced flexion was measured before and after treatment in ultrasound records. Functional and sport-specific outcomes were evaluated by means of a questionnaire, which also contained instructions for self-measurement of finger range of motion and finger strength.
  
  
  RESULTS
  Forty-seven complete pulley ruptures in 45 rock climbers (mean age, 33.4 years; range, 21.8-56.2 years) were included in the study. In the 39 patients who had follow-up ultrasound examination, PPS treatment decreased mean ± SD TPD from 4.4 ± 1.0 mm to 2.3 ± 0.6 mm after A2 pulley rupture and from 2.9 ± 0.7 mm to 2.1 ± 0.5 mm after A4 pulley rupture. Tendon-phalanx distance was reduced in all patients. Finger range of motion (n = 42) and finger strength (n = 22) did not differ significantly between treated and contralateral sides. Of the 43 climbers who completed questionnaires, 38 had regained their previous climbing level a mean 8.8 months after pulley rupture; 1 reported reduced finger dexterity; 39 assessed their treatment results to be good, and 4 to be very good.
  
  
  CONCLUSIONS
  The PPS is an effective conservative treatment modality for pulley ruptures, which reduces TPD and enables the patient to regain previous finger function.
authors.affiliation: Department of Orthopedics, Balgrist University Hospital, Zurich, Switzerland. Electronic address: micha-sch@gmx.ch.
authors.forename: Micha
authors.initials: M
authors.lastname: Schneeberger
authors.affiliation: Department of Orthopedics, Balgrist University Hospital, Zurich, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schweizer
mesh_terms: D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009051:Mountaineering / Q000293:injuries*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012421:Rupture / Q000628:therapy*; D013165:Splints; D013708:Tendon Injuries / Q000628:therapy; D013710:Tendons / Q000503:physiopathology; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
keywords: bowstringing; finger injury; flexor tendon; pulley rupture; rock climbing