Mitsionis G, Fischer K J, Bastidas J A, Grewal R, Pfaeffle H J, Tomaino M M
Musculoskeletal Research Center, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, PA 15213, USA.
J Hand Surg Br. 2000 Feb;25(1):90-4. doi: 10.1054/jhsb.1999.0332.
We investigated residual digital flexor pulley strengths after 75% excision of the A2 and A4 pulleys. For direct pull-off tests, A2 and A4 pulleys from cadaveric fingers were tested by pulling on a loop of flexor digitorum profundus tendon through the pulley. For functional loading tests, fingers were positioned with the metacarpophalangeal joint flexed to 90 degrees for A2 testing, and with the proximal interphalangeal joint in 90 degrees flexion for A4 testing (with all other joints in full extension). Excision of 75% of A2 and A4 pulleys reduced pulley strengths determined by both testing methods. For the functional loading tests, which are more clinically relevant, mean tendon forces at failure after partial excision of A2 and A4 pulleys were 224 and 131 N respectively, which is sufficient to withstand flexor tendon forces expected during activities of daily living.
我们研究了A2和A4滑车切除75%后指屈肌滑车的残余强度。在直接拉脱试验中，通过拉动穿过滑车的指深屈肌腱环来测试尸体手指的A2和A4滑车。在功能负荷试验中，测试A2时掌指关节屈曲90度，测试A4时近端指间关节屈曲90度（其他关节均完全伸展）。切除75%的A2和A4滑车会降低两种测试方法所测定的滑车强度。对于更具临床相关性的功能负荷试验，A2和A4滑车部分切除后失效时的平均肌腱力分别为224 N和131 N，这足以承受日常生活活动中预期的屈肌腱力。
