Article
Ultrasound diagnostics of A3 pulley injuries in multiple pulley injuries to define indication for a surgical repair
Search Medline for
Authors
-
Volker Schöffl
- Zentrum für interdisziplinäre Sportmedizin, Klinik für Orthopädie und Unfallchirurgie, Klinikum Bamberg, Bamberg, Germany
-
Johannes Deeg
- Department of Radiology, University Innsbruck, Innsbruck, Austria
-
Christoph Lutter
- Klinik für Orthopädie und Unfallchirurgie, Klinikum Bamberg, Bamberg, Germany
-
Thomas Bayer
- Department of Radiology, University Erlangen-Nuremberg, Erlangen, Germany
-
Isabelle Schöffl
- Department of Pediatric Cardiology, University Erlangen-Nuremberg, Erlangen, Germany
| Published: | February 6, 2020 |
|---|
Outline
Text
Objectives/Interrogation: The pulley rupture is the most common injury in sport climbing. Ruptures of the A2 and A4 pulleys have been studied extensively, and ultrasound has proven to be a highly sensitive and specific tool for their diagnosis. The diagnostics of an adjunct A3 pulley injury is crucial in suspected multiple pulley injuries to define a indication for a surgical repair. As the correct diagnosis of A3 pulley rupture remains a challenge we investigated a novel approach to this pathology.
Methods: fingers from 6 cadaver hands presenting intact pulley systems were compared to 9 fingers from 6 cadaver hands with missing A2 to A4 pulleys, but which featured a repair using the new surgical technique. Each finger was then fixed to an isokinetic loading device which loaded the finger until repair failure or a fracture (first event) occurred. The forces in the flexor tendons were recorded for each finger.
Results and Conclusions: Comparing the forces recorded at the moment of the first event, the forces in the control group were significantly higher (292.4 N) for FDP than in the group with the operated fingers (212.4 N). Although the forces recorded for FDS at the moment of failure were also higher in the control group, the difference did not reach significance (216.3 N vs. 158.2 N). The most common event in the operated fingers was a graft failure. A fracture of the bone due to the drill hole was never observed.
Comparing the forces recorded at the moment of the first event, the forces in the control group were significantly higher (292.4 N) for FDP than in the group with the operated fingers (212.4 N). Although the forces recorded for FDS at the moment of failure were also higher in the control group, the difference did not reach significance (216.3 N vs. 158.2 N). The most common event in the operated fingers was a graft failure. A fracture of the bone due to the drill hole was never observed.
