Abstract
Rock climbing has increased in popularity over the past two decades. Closed traumatic rupture of the finger flexor tendon pulleys is rare among the general population but is seen much more commonly in rock climbers. This article reviews the anatomy and biomechanics of the finger flexor tendon pulleys, how they may be injured in rock climbing and how these injuries are best diagnosed and managed.
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References
Schöffl V, Hochholzer T (2003) Pulley injuries in rock climbers. Wild Environ Med 14(2):94–100
Schöffl V et al (2006) Strength measurements and clinical outcome after pulley ruptures in climbers. Med Sci Sports Exerc 38(4):637–643
Doyle JR (2001) Palmar and digital flexor tendon pulleys. Clin Orthop Relat Res 383:84–96
Moutet F (2003) Flexor tendon pulley system: anatomy, pathology, treatment. Chir Main 22:1–12
Lin G, Cooney P, An K (1990) Mechanical properties of human pulleys. J Hand Surg 15(B):429–434
Schweizer A (2001) Biomechanical properties of the crimp grip position in rock climbers. J Biomech 34:217–223
Bollen SR (1990) Upper limb injuries in elite rock climbers. J R Coll Surg Edinb 35:18–20
Bollen SR (1990) Injury to the A2 pulley in rock climbers. J Hand Surg 15(B):268–270
Bollen SR (1988) Soft tissue injuries in extreme rock climbers. Br J Sports Med 22:145–147
Bollen SR, Gunson CK (1990) Hand injuries in competition climbers. Br J Sports Med 24:16–18
Tropet Y et al (1990) Closed traumatic rupture of the ring finger flexor tendon pulley. J Hand Surg 15(A):745–747
Schöffl I et al (2009) The influence of concentric and eccentric loading on the finger pulley system. J Biomech 42(13):2124–2128
Moor BK, Nagy L, Snedeker JG, Schweizer A (2009) Friction between finger flexor tendons and the pulley system in the crimp grip position. Clin Biomech 24(1):20–25
Schöffl I et al (2000) The influence of the crimp and slope grip position on the finger pulley system. J Biomech 42(13):2183–2187
Schweizer A, Hudek R (2011) Kinetics of crimp and slope grip in rock climbing. J Appl Biomech 27(2):116–121
Bannister P, Foster P (1986) Upper limb injuries associated with rock climbing. Br J Sports Med 20:20–55
Shea KG, Shea OF, Meals RA (1992) Manual demands and consequences of rock climbing. J Hand Surg 17(A):200–205
Holtzhausen LM, Noakes TD (1996) Elbow, forearm, wrist and hand injuries among sport rock climbers. Clin J Sports Med 6:196–203
Schöffl V, Schöffl I (2010) Isolated cruciate pulley injuires in rock climbers. J Hand Surg Eur Vol 35(3):245–246
Schöffl V, Jűngart J (2006) Closed flexor pulley injuries in non-climbing activities. J Hand Surg 31(5):806–810
Lourie GM et al (2011) Annular flexor pulley injuries in professional basball pitchers: a case series. Am J Sports Med 39(2):421–424
Gabl et al (1998) Disruption of the finger flexor pulley system in elite rock climbers. Am J Sports Med 26:651–655
Bodner G et al (1999) Diagnosis of digital flexor tendon annular pulley disruption: comparison of high frequency ultrasound and MRI. Ultraschall Med 20:131–136
Gabl et al (1996) Rupture or stress injury of the flexor tendon pulleys? Early diagnosis with MRI. Handchir Mikrochir Plast Chir 28:317–321
Kaluser A et al (2002) Diagnosis of climbing related overuse injuries. Radiologe 42:788–798
Klauser et al (2000) Value of high resolution ultrasound in the evaluation of finger injuries in extreme sport climbers. Ultraschall Med 21:73–78
McGeorge DD, McGeorge S (1990) Diagnostic medical ultrasound in the management of hand injuries. J Hand Surg 15(B):256–261
Logan et al (2004) Acute hand and wrist injuries in experienced rock climbers. Br J Sports Med 38:545–548
Schweizer A (2000) Biomechanical effectiveness of taping the A2 pulley in rock climbers. J Hand Surg 25(B):102–107
Straub G (2000) Musculoskeletal problems in rock climbing—a review. Wein Med Wochenschr 150:186–190
Warme WJ, Brooks D (2000) The effect of circumfrential taping on flexor tendon pulley failure in rock climbers. Am J Sports Med 28(5):674–678
Schöffl I et al (2007) The impact of taping after finger flexor tendon pulley ruptures in rock climbing. J Appl Biomech 23(1):52–62
Gabl M, Reinhart M, Lutz M (2000) The use of a graft from the second extensor compartment to reconstruct the A2 flexor pulley in the long finger. J Hand Surg 25(B):98–101
Lin et al (1989) Functional anatomy of the human digital flexor pulley system. J Hand Surg 14(A):949–956
Lin et al (1989) Biomechanical analysis of finger flexor pulley reconstruction. J Hand Surg 14(B):278–282
Widstom et al (1989) A mechanical study of six digital pulley reconstruction techniques: part I. Mechanical effectiveness. J Hand Surg 14(A):821–825
Widstrom et al (1989) A mechanical study of six digital pulley reconstruction techniques: part II. Strength of individual reconstructions. J Hand Surg 14(A):826–829
Schöffl V, Schöffl I (2006) Injuries to the finger flexor pulley system in rock climbers: current concepts. J Hand Surg 31(A):647–654
Voulliaume et al (2004) Surgical repair in flexor tendon pulley rupture in high level rock climbing. Chir Main 23:243–248
Arora et al (2007) Reconstructon of the digital flexor pulley system: a retrospective comparison of two methods of treatment. J Hand Surg Eur Vol 32(1):60–66
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Crowley, T.P. The Flexor Tendon Pulley System and Rock Climbing. J Hand Microsurg 4, 25–29 (2012). https://doi.org/10.1007/s12593-012-0061-3
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DOI: https://doi.org/10.1007/s12593-012-0061-3