Abstract
The tendon-pulley geometry and gliding resistance with and without the A3 pulley were
compared in 6 fresh human cadaver fingers. We measured the x-ray images of the distal
A2 pulley-tendon angle and proximal A4 pulley-tendon angle with varying degrees of
proximal interphalangeal joint flexion between 0° and 120° before and after A3 pulley
resection. The gliding resistance of the flexor digitorum profundus tendon under the
A2 pulley was also measured at varying tendon-pulley angles. With the A3 pulley removed,
the tendon-pulley angle significantly increased compared with the A3 intact state.
The gliding resistance between tendon and pulley quadratically increased as the tendon-pulley
angle increase from 0° to 60°. These results indicate that the A3 pulley might serve
to reduce tendon-pulley gliding resistance by reducing the tendon-pulley angle during
finger flexion. (J Hand Surg 2000;25A:270–276. Copyright © 2000 by the American Society
for Surgery of the Hand.)
Keywords
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References
- Flexor tendon-pulley interaction after tendon repair: a biomechanical study.J Hand Surg. 1995; 20B: 573-577
- The mechanical efficiency of the pulley system in normal digits compared with a reconstructed system using the “belt loop” technique.J Hand Surg. 1987; 12A: 596-601
- Mechanical analysis of the palmar aponeurosis pulley in human cadavers.J Hand Surg. 1996; 21A: 240-244
- Anatomy of the flexor tendon sheath and pulley system: a current review.J Hand Surg. 1989; 14A: 349-351
- Functional anatomy of the human digital flexor pulley system.J Hand Surg. 1989; 14A: 949-956
- Reconstruction of the flexor pulley: the effect of the tension and source of the graft in an in vitro dog model.J Bone Joint Surg. 1998; 80A: 699-703
- A method for measurement of friction between tendon and pulley.J Orthop Res. 1995; 13: 83-89
- Experimental study of optimal location of flexor tendon pulleys.Plast Reconstr Surg. 1969; 43: 125-129
- Efficiency of the flexor tendon pulley system in human cadaver hands.J Hand Surg. 1996; 21A: 444-450
- A biomechanical study of the flexor digitorum superficialis: effects of digital pulley excision and loss of the flexor digitorum profundus.J Hand Surg. 1997; 22A: 328-335
- Measurement of friction between pulley and flexor tendon.Biomed Sci Instrum. 1993; 29: 1-7
- Anatomy and pathomechanics of the flexor pulley system.J Hand Ther. 1987; 2: 138-141
- Anatomy of the finger flexor tendon sheath and pulley system.J Hand Surg. 1988; 13A: 473-484
- Gliding characteristics of tendon repair in partially lacerated canine flexor digitorum profundus tendons.Orthop Trans. 1999; 23 (abstr): 120
- A comparative study of two methods of controlled mobilization of flexor tendon repairs in zone 2.J Hand Surg. 1998; 23B: 41-45
- Flexor tendon repair in zone 2C.J Hand Surg. 1994; 19B: 72-75
- A new type of flexor tendon repair: biomechanical evaluation by cyclic loading, ultimate strength and assessment of pulley friction in vitro.J Hand Surg. 1995; 20B: 578-583
- Work of flexion after tendon repair with various suture methods: a human cadaveric study.J Hand Surg. 1995; 20B: 310-313
- The interior of the flexor tendon sheath of the finger: the functional significance of its structure.J Bone Joint Surg. 1988; 70B: 583-587
- The boundary lubricating ability of phospholipid on flexor tendon of rabbit.Orthop Trans. 1999; 23 (abstr): 316
- Effect of pulley excision on flexor tendon biomechanics.J Orthop Res. 1986; 4: 96-101
- Biomechanical analysis of finger flexor pulley reconstruction.J Hand Surg. 1989; 14B: 278-282
Article info
Publication history
Accepted:
December 6,
1999
Received:
July 29,
1999
Footnotes
*Supported by grant no. AR 44391 from the National Institutes of Health.
**No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of his article.
*Reprint requests: Peter C. Amadio, MD, Mayo Clinic, 200 First St SW, Rochester, MN 55905.
**0363-5023/00/25A02-0028$3.00/0
♢J Hand Surg 2000;25A;270–276.
Identification
Copyright
© 2000 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
