Release of the A4 Pulley to Facilitate Zone II Flexor Tendon Repair Journal of Hand Surgery


Release of the A4 Pulley to Facilitate Zone II Flexor Tendon Repair Journal of Hand Surgery

The flexor pulley system of the hand is a complex structure that co-ordinates flexion of the digits. It consists of: Long flexor tendons - and their associated synovial sheaths. Annular pulleys - 5 associated with each finger, 2 associated with the thumb. Cruciate pulleys - 3 associated with each finger.


The Flexor Pulley System of the Hand Annular Cruciate Oblique TeachMeAnatomy

Functional Anatomy of the Hand Introduction The hand contains a number of joints that allow complex actions, such as manipulating, gripping and grasping objects. Optimal hand function requires adequate strength, sensation, range of motion, and dexterity.


a A diagram of the flexor pulley system of the finger with permission... Download Scientific

The cruciate pulleys, allows the flexor sheath to concertina, that is to change length during flexion-extension. The thumb has an AI pulley volar to the MP joint and an A2 pulley volar to the IP joint. The oblique pulley is the largest and most important pulley in the thumb and lies between A1 and A2 obliquely across the proximal phalanx.


Pulley Injuries Explained (Part 1) — Grassroots Physical Therapy

summary. Flexor Tendon Injuries are traumatic injuries to the flexor digitorum superficialis and flexor digitorum profundus tendons that can be caused by laceration or trauma. Diagnosis is made clinically by observing the resting posture of the hand to assess the digital cascade and the absence of the tenodesis effect.


Flexor Tendon Repair Surgical Repair TeachMeSurgery

The flexor pulley system of finger of hand consist of localized thickenings of the digital sheath. The index, middle, ring, and small fingers usually contain five annular pulleys (A1 to A5) and three cruciate pulleys (C1 to C3). Wuertzer SD, Pacholke DA. High-resolution 3-T MRI of the fingers: review of anatomy and common tendon and ligament.


Hand Anatomy Concise Medical Knowledge

1 Images Flexor Pulley System-Fingers Annular ligaments A2 and A4 are critical to prevent bowstringing most biomechanically important A1, A3, and A5 overlie the MP, PIP and DIP joints respectively originate from palmar plate A1 pulley most commonly involved in trigger finger Cruciate pulleys


The Flexor Pulley System of the Hand Annular Cruciate Oblique TeachMeAnatomy

Doyle JR. Anatomy and function of the palmar aponeurosis pulley. J Hand Surg [Am]. 1990 Jan. 15(1):78-82. [QxMD MEDLINE Link]. Doyle JR, Blythe WF. Anatomy of the flexor tendon sheath and pulleys of the thumb. J Hand Surg [Am]. 1977 Mar. 2(2):149-51. [QxMD MEDLINE Link]. Bunnell S. Repair of tendons in the fingers and description of two new.


Mechanized Human Hands Neuroscience News

Definition/Description The pulley system is made of thickened areas of the flexor tendon sheath and plays an important role in: Flexion. Accurate tracking of tendons. Maintaining apposition of tendons and bones across joints preventing them from pulling away and bowstringing. Provides fulcrum to elicit movement (flexion and extension) [1]


Finger flexor tendon sheath and pulley system Alila Medical Images

From Lin GT, Amadio PC, Cooney WP: Anatomy of human digital flexor pulleys (accepted for publication by J Hand Surg). flGURE 3. The cruciate pulleys have one fixed attachment, to bone and one moveable attachment, to volar plate. From Lin GT, Amadio PC, Cooney WP: Anatomy of human digital flexor pulleys (accepted for publication by J Ha~d Surg).


Wrist and hand Basicmedical Key

A trigger finger, sometimes referred to as a trigger thumb or stenosing tenosynovitis, can occur if one of three things happen: 1. The tendon enlarges (does not fit through pulley well); 2. The lining increases in thickness (does not fit through pulley well); 3. the pulley becomes thicker (the opening for the tendon gets smaller).


Palmar view of hand anatomy including tendons and pulleys Hand anatomy, Anatomy images, Anatomy

The bony anatomy of the hand and wrist truly begins at the distal forearm with the radius and ulna. Distal to these are eight carpal bones: scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, and hamate. The carpus articulates with five metacarpals which in turn articulate with the phalanges.


Flexor Pulley System Anatomy, Injury, and Management Journal of Hand Surgery

The oblique ligament is the most important pulley for the FPL tendon. [3] If both the A1 and oblique ligaments are cut then bowstringing of the FPL tendon will occur. The Av ligament is not present in 7% of individuals. [3] Dysfunctional excursion of the FPL tendon through the pulley system results in trigger thumb. Go to: Embryology


Alila Medical Media Finger tendon sheath and pulleys labeled. Medical illustration

A thorough awareness of hand and upper limb anatomy is vital to understanding injuries to these regions, planning subsequent management, and anticipating complications. We will review anatomy here systematically.. Pulleys are either cruciate and annular (Fig. 1.8). Annular pulleys function to prevent bowstringing.


Pulley Injuries Explained (Part 1) — Grassroots Physical Therapy

The coronal plane is important for evaluating the collateral ligaments and articular cartilage, and the sagittal plane is important for evaluating the flexor and extensor tendons, volar plate, pulleys, and articular cartilage.


Varied Anatomy of the Thumb Pulley System Implications for Successful Trigger Thumb Release

The normal anatomy of the pulley system was studied at extension and flexion without and with MR tenography. Pulley lengths were measured, and anatomic correlation was performed. Pulley lesions were created and studied at flexion, extension, and forced flexion. Two radiologists reviewed the studies in blinded fashion.


Hand Pulleys Physiopedia

Pulley Lesion of the Fingers Mark Awh, M.D. Clinical History: A 28 year-old rock climber presents with persistent pain and swelling at the index finger. (1a) A T2-weighted sagittal image with fat-suppression and (1b) a proton density-weighted fat-suppressed axial image are provided. What are the findings" What is your diagnosis? 1a 1b Figure 1:

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