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OrthoVellum

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Not affiliated with the Royal Australasian College of Surgeons.

Hand & Upper Limb
intermediate
X-Type

Flexor Pulley System

Hand Anatomy

A 35-year-old rock climber presents with painful swelling at the base of his ring finger after feeling a "pop" during a difficult climb. He can flex the finger but with weakness and pain. There is tenderness over the A2 pulley region, and bowstringing of the flexor tendon is noted with resisted finger flexion. Regarding the flexor pulley system:

Mark each as TRUE or FALSE

A

The digital flexor sheath contains five annular (A1-A5) and three cruciate (C1-C3) pulleys; annular ...

B

The A1 pulley is located at the level of the MCP joint over the volar plate and is the site of trigg...

C

The digital sheath has 10 annular pulleys; A1 and A3 are most critical biomechanically; cruciate pul...

D

Pulley injuries are common in rock climbers from crimp grip positions generating high forces; A2 pul...

E

Pulley reconstruction options include extensor retinaculum autograft (preferred), palmaris longus, o...

Answer the questions to see explanations

Click T (True) or F (False) for each option