scholarly journals The Flexor Tendon Pulley System and Rock Climbing

2016 ◽  
Vol 04 (01) ◽  
pp. 25-29 ◽  
Author(s):  
Timothy Crowley
Keyword(s):  
Flexor Tendon ◽  
Rock Climbing ◽  
Pulley System

scholarly journals Mechanical loading of primate fingers on vertical rock surfaces

2021 ◽  
Vol 117 (11/12) ◽  
Author(s):  
Michael C. Everett ◽  
Marina C. Elliott ◽  
David Gaynor ◽  
Austin C. Hill ◽  
Jesse Casana ◽  
...  
Keyword(s):  
South Africa ◽  
Mechanical Loading ◽  
Nature Reserve ◽  
Flexor Tendon ◽  
Three Dimensional ◽  
Vertical Surface ◽  
Rock Climbing ◽  
Rock Surface ◽  
Induce Stress ◽  
Pulley System

Mechanical loading of finger bones (phalanges) can induce angular curvature, which benefits arboreal primates by dissipating forces and economising the recruitment of muscles during climbing. The recent discovery of extremely curved phalanges in a hominin, Homo naledi, is puzzling, for it suggests life in an arboreal milieu, or, alternatively, habitual climbing on vertical rock surfaces. The importance of climbing rock walls is attested by several populations of baboons, one of which uses a 7-m vertical surface to enter and exit Dronkvlei Cave, De Hoop Nature Reserve, South Africa. This rock surface is an attractive model for estimating the probability of extreme mechanical loading on the phalanges of rock-climbing primates. Here we use three-dimensional photogrammetry to show that 82–91% of the climbable surface would generate high forces on the flexor tendon pulley system and severely load the phalanges of baboons and H. naledi. If such proportions are representative of vertical rock surfaces elsewhere, it may be sufficient to induce stress-mitigating curvature in the phalanges of primates.

Predictors of outcome after primary flexor tendon repair in zone 1, 2 and 3

2016 ◽  
Vol 41 (8) ◽  
pp. 793-801 ◽  
Author(s):  
I. Z. Rigo ◽  
M. Røkkum
Keyword(s):  
Flexor Tendon ◽  
Linear Regression Analysis ◽  
Tendon Repair ◽  
Tendon Sheath ◽  
Multiple Linear Regression Analysis ◽  
Level Of Evidence ◽  
Pulley System ◽  
Skeletal Injury ◽  
Active Mobilization

We retrospectively reviewed the outcomes of flexor tendon repairs in zones 1, 2 and 3 in 356 fingers in 291 patients between 2005 and 2010. The mean (standard deviation) active ranges of motion of two interphalangeal joints of the fingers were 98° (40) and 114° (45) at 8 weeks postoperatively and at the last follow-up (mean 7 months, range 3–98), respectively. Using the Strickland criteria, ‘excellent’ or ‘good’ function was obtained in 95 (30%) out of 322 fingers at 8 weeks and 107 (48%) out of 225 fingers at the last follow-up. A total of 48 (13%) fingers required reoperation because of rupture, adhesion, contracture or other complications. The prevalence of rupture was 4%. We carried out multiple linear regression analysis to identify the predictors of the active digital motion. The following variables were found as negative predictors: age; smoking; injury localization between subzones 1C and 2C; injury to the little finger; the extent of soft tissue damage; concomitant skeletal injury; delay to surgery; use of a 2-strand Kessler repair technique; attempted suture or preservation of the tendon sheath–pulley system; and resecting or leaving the concomitant superficial flexor tendon cuts untreated. Analysing the 8 weeks results of tendon repairs in zones 1 and 2, early active mobilization was found to be superior to Kleinert’s regime. Level of evidence: III

The Direct Midlateral Approach with Lateral Enlargement of the Pulley System for Repair of Flexor Tendons in Fingers

1996 ◽  
Vol 21 (4) ◽  
pp. 463-468 ◽  
Author(s):  
A. MESSINA ◽  
J. C. MESSINA
Keyword(s):  
Flexor Tendon ◽  
Skin Flap ◽  
Tendon Repair ◽  
Tendon Sheath ◽  
Flexor Tendon Repair ◽  
Anterior Compartment ◽  
Pulley System ◽  
Neurovascular Pedicle ◽  
Anchoring System ◽  
Palmar Skin

The direct midlateral approach and the lateral enlarging procedure of the pulley system have been utilized in our service since 1972. The incision runs directly behind the neurovascular pedicle, which is left in the palmar skin flap of the anterior compartment of the finger, in order to ensure its blood supply and sensibility. The transverse digital lamina of Landsmeer’s skin anchoring system and Cleland’s ligament are preserved and are used to perform a lateral enlargement of the pulleys after tendon repair. The technique allows wide surgical exposure of the digital fibro-osseous tunnel, enlargement and reconstruction of the pulley system and tendon sheath, flexor tendon repair (using the technique of choice) and reduces postoperative impingement in zone 2.

scholarly journals Investigation Into the Functional Anatomy of the Flexor Tendon Pulley System of the Hand

2017 ◽  
Vol 47 ◽  
pp. S68
Author(s):  
G. Alanazi ◽  
J. Langschmidt ◽  
P. Rust
Keyword(s):  
Flexor Tendon ◽  
Functional Anatomy ◽  
Pulley System

scholarly journals Flexor tendon repair: a comparative study between a knotless barbed suture repair and a traditional four-strand monofilament suture repair

2013 ◽  
Vol 39 (1) ◽  
pp. 40-45 ◽  
Author(s):  
C. W. Joyce ◽  
K. E. Whately ◽  
J. C. Chan ◽  
M. Murphy ◽  
F. J. O’Brien ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Biomechanical Testing ◽  
Tendon Repair ◽  
Barbed Suture ◽  
Suture Repair ◽  
Flexor Tendon Repair ◽  
Cross Sectional ◽  
Pulley System ◽  
Suture Group

We compared the tensile strength of a novel knotless barbed suture method with a traditional four-strand Adelaide technique for flexor tendon repairs. Forty fresh porcine flexor tendons were transected and randomly assigned to one of the repair groups before repair. Biomechanical testing demonstrated that the tensile strengths between both tendon groups were very similar. However, less force was required to create a 2 mm gap in the four-strand repair method compared with the knotless barbed technique. There was a significant reduction in the cross-sectional area in the barbed suture group after repair compared with the Adelaide group. This would create better gliding within the pulley system in vivo and could decrease gapping and tendon rupture.

Histogenesis and Morphology of the Flexor Tendon Pulley System in the Human Embryonic Hand

2000 ◽  
Vol 25 (2) ◽  
pp. 175-179 ◽  
Author(s):  
M. C. SBERNARDORI ◽  
G. FENU ◽  
A. PIRINO ◽  
C. FABBRICIANI ◽  
A. MONTELLA
Keyword(s):  
Electron Microscope ◽  
Flexor Tendon ◽  
Middle Layer ◽  
Tendon Sheath ◽  
Pulley System ◽  
Outermost Layer ◽  
Extensor Tendons ◽  
Flexor Tendons ◽  
Mesenchymal Tissue

The number, position, structural and ultrastructural features of the flexor tendon pulley system in six human embryonic hands, aged from 6 to 12 weeks, were studied by light and electron microscope. The pulley system can be recognized from the ninth week; later, at 12 weeks, the structures are easily identified around the flexor tendon in positions closely correlated to those found during post-natal growth and in the adult hand. Structurally and ultrastructurally the pulleys are not simply thickened portions of the sheath. They are formed by three layers: an inner layer, one or two cells thick, probably representing a parietal synovial tendon sheath; a middle layer formed by collagen bundles and fibroblasts whose direction is mainly perpendicular to the underlying phalanx; and an outermost layer consisting of mesenchymal tissue with numerous vessels which extends dorsally in an identical layer, forming a ring that includes flexor and extensor tendons and the cartilaginous model of the phalanx. The pulley does not have a semicircular shape but a much more complicated one, owing to the middle layer which in part runs dorsally and in part ventrally, under the flexor tendons.

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