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Effect of pulley excision on flexor tendon biomechanics
Author(s) -
Peterson William W.,
Manske Paul R.,
Bollinger Bruce A.,
Lesker Peggy A.,
McCarthy John A.
Publication year - 1986
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.1100040112
Subject(s) - pulley , tendon , excursion , biomechanics , medicine , anatomy , engineering , structural engineering , political science , law
Flexor tendon function following excision of various portions of the fibro‐osseous pulley system was measured biomechanically using a tensile testing machine. The biomechanical parameters measured were tendon excursion (the excursion of the tendon required to fully flex the digit) and work of flexion (the area under the force‐excursion curve, representing all the forces that resist tendon flexion). In this experiment, work of flexion included the forces necessary to accomplish full digital flexion against a 15‐g counterweight, as well as the frictional forces that resist tendon gliding. The results indicate that the work of flexion was affected to a greater degree by pulley loss than was tendon excursion, suggesting that it is a more sensitive measurement of tendon function. A 2 was found to be the single most important pulley for flexor tendon function, followed by A 4 . However, both A 2 and A 4 had to be present if near‐normal hand function was to be achieved; sacrificing the A 1 pulley was not associated with a significant loss of flexion. The “pulley effect” of the skin and soft tissue as a supplement to the fibro‐osseous pulleys in reducing tendon bow‐stringing was also noted. Although the parameters of tendon excursion and work of flexion were used in this study to determine the effect of pulley loss on tendon function, they can also be used to evaluate other flexor tendon studies, such as pulley reconstruction.