![]() J Hand Surg Am 1999 24:310-314.Necessary cookies are absolutely essential for the website to function properly. Feasibility of partial A2 and A4 pulley excision: effect on finger flexor tendon biomechanics. 27 Mitsionis G, Bastidas JA, Grewal R, Pfaeffle HJ, Fischer KJ, Tomaino MM.The mechanical effect of partial resection of the digital fibrous flexor sheath. Paris, France: Expansion Scientifique Française, 1995 161-167. La main du sportif: monographie du groupe d’étude de la main. 25 Pequignot JP, Duval MA, Giordano P.Pathomechanics of closed rupture of the flexor tendon pulleys in rock climbers. 24 Marco RA, Sharkey NA, Smith TS, Zissimos AG.23 Lin GT, Cooney WP, Amadio PC, An KN.Bowstring injury of the tendon pulley system: MR Imaging. 22 Parellada JA, Balkissoon AR, Hayes CW, Conway WF.Diagnosis of digital pulley rupture by computed tomography. 21 Le Viet D, Rousselin B, Roulot E, Lantieri L, Godefroy D.Closed ruptures of the flexor digitorum tendons: MRI evaluation. 20 Drape JL, Tardif-Chastanet de Gery S, Silbermann-Hoffmann O, et al.Complications of flexor tendon repair in the hand: MR imaging assessment. 19 Drape JL, Silbermann-Hoffmann O, Houvet P, et al.Flexor tendon tears in the hand: use of MR imaging to diagnose degree of injury in a cadaver model. 18 Rubin DA, Kneeland JB, Kitay GS, Naranja RJ, Jr.Ultrasonic assistance in the diagnosis of hand flexor tendon injuries. 17 Wang PT, Bonavita JA, DeLone FX, Jr, McClellan RM, Witham RS.Colour Doppler ultrasound examination of hand tendon pathologies: a preliminary report. 16 Buyruk HM, Stam HJ, Lameris JS, Schut HA, Snijders CJ.High resolution sonography of the flexor tendons in trigger fingers. 15 Serafini G, Derchi LE, Quadri P, et al.The role of ultrasound in the management of zone 1 flexor tendon injuries. Diagnostic medical ultrasound in the management of hand injuries. Ultrasonic examination of the flexor tendons of the fingers. 11 Khaleghian R, Tonkin LJ, De Geus JJ, Lee JP.Disruption of the finger flexor pulley system in elite rock climbers. 10 Gabl M, Rangger C, Lutz M, Fink C, Rudisch A, Pechlaner.Closed traumatic rupture of finger flexor pulleys. Subcutaneous rupture of long finger flexor pulleys in rock climbers: 12 case reports. 8 Moutet F, Guinard D, Gerard P, et al.Closed traumatic rupture of the ring finger flexor tendon pulley. ![]() 7 Tropet Y, Menez D, Balmat P, Pem R, Vichard P.Injury to the A2 pulley in rock climbers. Functional anatomy of the human digital flexor pulley system. 4 Lin GT, Amadio PC, An KN, Cooney WP.Anatomy and function of the palmar aponeurosis pulley. Anatomy and biomechanics of the digital flexor tendons. Anatomy of the finger flexor tendon sheath and pulley system. ![]() Indirect diagnosis was successful with all methods with forced flexion.ĬONCLUSION: MR imaging and US provide means of direct finger pulley system evaluation. Direct lesion diagnosis was possible with MR imaging and US in 79%–100% of cases, depending on lesion type. No significant differences in pulley lengths were measured at MR, US, or pathologic examination ( P = .512). CT did not allow direct pulley visualization. US showed the A2 pulley in all cases and the A4 pulley in eight (67%). MR tenography showed the A3 (proximal interphalangeal) and A5 (distal interphalangeal) pulleys in 10 (83%) and nine (75%) cases, respectively. RESULTS: MR imaging demonstrated A2 (proximal phalanx) and A4 (middle phalanx) pulleys in 12 (100%) of 12 cases, without and with tenography. Two radiologists reviewed the studies in blinded fashion. Pulley lesions were created and studied at flexion, extension, and forced flexion. Pulley lengths were measured, and anatomic correlation was performed. The normal anatomy of the pulley system was studied at extension and flexion without and with MR tenography. MATERIALS AND METHODS: Three groups of cadaveric fingers underwent computed tomography (CT), magnetic resonance (MR) imaging, and ultrasonography (US). PURPOSE: To describe the normal anatomy of the finger flexor tendon pulley system, with anatomic correlation, and to define criteria to diagnose pulley abnormalities with different imaging modalities.
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