title: Clinical results of releasing the entire A2 pulley after flexor tendon repair in zone 2C.
abstract: We report the results of complete release of the entire A2 pulley after zone 2C flexor tendon repair followed by early postoperative active mobilization in seven fingers and their comparisons with 33 fingers with partial A2 pulley release. In seven fingers, release of the entire A2 pulley was necessary to allow free gliding of the repairs in five fingers and complete release of both the A2 and C1 pulleys was necessary in two. No bowstringing was clinically evident in any finger. Two fingers required tenolysis. Using Tang's criteria, the function of two digits was ranked as excellent, four good and one fair; there was no failure. The functional return in these seven fingers was similar with that in 33 fingers with partial A2 pulley release; in these patients only one finger required tenolysis. Our results support the suggestion that release of the entire A2 pulley together with the adjacent C1 pulley does not clinically affect finger motion or cause tendon bowstringing, provided that the other pulleys are left intact.
  
  
  METHODS
  IV.
authors.affiliation: Niigata Hand Surgery Foundation, Niigata, Japan kmoriya@k8.dion.ne.jp.
authors.forename: K
authors.initials: K
authors.lastname: Moriya
authors.affiliation: Niigata Hand Surgery Foundation, Niigata, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yoshizu
authors.affiliation: Niigata Hand Surgery Foundation, Niigata, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Tsubokawa
authors.affiliation: Niigata Hand Surgery Foundation, Niigata, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Narisawa
authors.affiliation: Niigata Hand Surgery Foundation, Niigata, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hara
authors.affiliation: Niigata Hand Surgery Foundation, Niigata, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Maki
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005384:Finger Joint; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*; D058971:Tenotomy; D016896:Treatment Outcome; D055815:Young Adult
keywords: A2 pulley; early active mobilization; flexor tendon injury; release; six-strand technique; zone 2C