Closed traumatic rupture of finger flexor pulleys

Bowers, William H.; Kuzma, Gary R.; Bynum, Donald K.

doi:10.1016/0363-5023(94)90183-x

Cited by 65 publications

(52 citation statements)

References 13 publications

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“…So far, every cadaver study has loaded the fingers in a concentric fashion, pulling on the tendons until rupture of one or several pulleys. However the mechanism leading to a pulley rupture as described by several authors is an eccentric movement of the fingers in the form of slipping of a foot off a foothold, leading to a passive opening of the fingers (Gabl et al, 1998;Moutet, 2003;Schöffl et al, 2003a, b), or in non-climbers as a consequence of a rapidly applied external load that forces the finger into sudden extension (Bowers et al, 1994;Le Viet et al, 1996). The injured climbers state that their injuries occur mainly at the end of a hard climbing day, when they are too tired to hold on to small ledges and the fingers open up .…”

Section: Discussionmentioning

confidence: 97%

“…All these mechanisms indicate an eccentric movement as the cause of the pulley rupture. Furthermore, after having identified this injury in rock climbers it was found that ruptures of the flexor tendon pulley system are not confined to climbers at all but that they can occur in any situation in which a flexed digit is subjected to a large and rapidly applied external load that forces the finger into sudden extension (Bowers et al, 1994;Le Viet et al, 1996;Schöffl and Jüngert, 2006). The aim of the specialization of the human finger flexor tendon and its sheath is assumed to keep friction to a minimum for optimal functionality.…”

Section: Introductionmentioning

confidence: 97%

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The influence of concentric and eccentric loading on the finger pulley system

Schöffl¹,

Oppelt²,

Jüngert³

et al. 2009

Journal of Biomechanics

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 97%

The influence of concentric and eccentric loading on the finger pulley system

Schöffl¹,

Oppelt²,

Jüngert³

et al. 2009

Journal of Biomechanics

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“…As the finger and the hand are exceptionally solicited in this activity, they experience the most injuries in rock climbing, and among these, the pulley rupture is the most common [1][2][3][4]. After having identified this previously unknown injury in rock climbers, it was found that ruptures of the flexor tendon pulley system are not confined to climbers [5][6][7]. They can occur in any situation in which a flexed digit is subjected to a large and rapidly applied external load that forces the finger into sudden extension [5][6][7].…”

Section: Introductionmentioning

confidence: 95%

“…After having identified this previously unknown injury in rock climbers, it was found that ruptures of the flexor tendon pulley system are not confined to climbers [5][6][7]. They can occur in any situation in which a flexed digit is subjected to a large and rapidly applied external load that forces the finger into sudden extension [5][6][7].…”

Section: Introductionmentioning

confidence: 97%

A new measuring technique for determining the forces acting on the pulley system of the finger

Schöffl¹,

Oppelt²,

Schweizer

et al. 2009

Sports Technol.

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In this study, a new force measuring technique was employed for determining the forces acting on the pulley system of the finger. An index and a ring finger of two separate cadavers (76 and 75 years of age) were placed in an isokinetic loading device in which the fingertip was fixed and loading was applied by pulling the two flexor tendons separately with increasing strength, while recording the forces occurring at the fingertip and in each of the two tendons. At the same time, we recorded the pressure underneath the pulleys using special sensors developed for this purpose. The fingers were loaded until a pulley rupture or an alternative event (fracture, tendon rupture) occurred. The whole loading process was recorded by digital camera. An A2 pulley rupture occurred in the index finger, while the ring finger fractured at the middle phalanx. The forces measured underneath the pulleys were smaller than the ones calculated by a mathematical model described in the literature. However, the forces measured and calculated showed the same characteristics during the loading process. More data is needed for validating the forces measured with these new pressure sensors. However, this pressure measuring technique represents a first approach for analyzing high forces in very confined spaces. r

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“…The main function of the flexor tendon pulley system, a fortification of the flexor tendon sheath, as described by Doyle and Blythe (1975) is to maintain the flexor tendons close to the bone, thus converting translation and force developed in the flexor muscle-tendon unit into rotation and torque at the finger joints. Damage to the flexor tendon pulley system can lead to a loss of strength across the full range of motion of the finger, a decreased range of motion, bowstringing and fixed flexion contracture of the proximal interphalangeal joint (PIP) (Bollen, 1988;Bowers et al, 1994;Savage, 1990;Tropet et al, 1990). The main mechanism leading to a pulley rupture has been described as a sudden overload of the pulley system with the fingers in the crimp grip position (Bollen, 1990a,b;Bowers et al, 1994;Moutet, 2003;Schöffl et al, 2006;Schöffl et al, 2003a,b).…”

Section: Introductionmentioning

confidence: 99%