Pulley reparation with direct suture technique: A mechanical study.

Abstract

One of the most common climbing injuries is finger pulley ruptures. Depending on the grade of injury, surgery may be required. Conventional techniques are tried and tested, but they all use autograft to reconstruct the pulley and some side effects have been observed. The present technique, direct suture of injured pulleys, not using autograft, has a minimal footprint and a normal tendon-bone distance after healing. This study aimed to verify the post-operative stability of the pulley repaired with direct suture. We performed rupture tests on the pulleys of 17 cadaver fingers via traction on the flexor tendons. Tests were carried out first on the native pulley and then on the sutured pulley. We measured the total tensile force and fingertip force and calculated the force of the A2 and A4 pulleys in each test. We found a significant difference in force between native (334.9 N) and sutured (59.0 N) A2 pulleys and in all other parameters. These results showed that direct suturing is a technique that allows the injured pulley to be properly positioned for regeneration with good stability but does not provide immediate resistance.